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Timing of onset of lithium relapse prevention in bipolar disorder: evidence from randomised trials.

Authors
  • Taylor, Matthew J1
  • 1 Consultant Psychiatrist,University Department of Psychiatry, Warneford Hospital,Oxford OX3 7JX,UKandClinical Senior Lecturer in Bipolar Disorder,Institute of Psychiatry, Psychology & Neuroscience, King's College London,UK. Email:[email protected]
Type
Published Article
Journal
The British journal of psychiatry : the journal of mental science
Publication Date
Nov 01, 2018
Volume
213
Issue
5
Pages
664–666
Identifiers
DOI: 10.1192/bjp.2018.177
PMID: 30246666
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

SummaryLithium is widely prescribed, but the timing of key effects remains uncertain. The timing of onset of its relapse prevention effects is clarified by placebo-controlled randomised trials (3 studies, n = 1120). Lithium reduced relapse into any mood episode over the first 2 weeks of treatment (hazard ratio 0.40, 95% CI 0.16-0.97). Fewer manic relapses were evident within the first 4 weeks, however, early effects on depressive relapse were not demonstrated. There is an early onset of lithium relapse prevention effects in bipolar disorder, particularly against manic relapse. Full effects against depressive relapse may develop over a longer period.Declaration of interestM.J.T. reports personal fees from Sunovion, Otsuka, Lundbeck, outside the submitted work.

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