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Quetiapine v. lithium in the maintenance phase following a first episode of mania: Randomised controlled trial

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Version 2 2024-06-04, 02:14
Version 1 2017-04-03, 15:18
journal contribution
posted on 2024-06-04, 02:14 authored by Michael BerkMichael Berk, R Daglas, O Dandash, M Yücel, L Henry, K Hallam, C Macneil, M Hasty, C Pantelis, BP Murphy, L Kader, S Damodaran, MTH Wong, P Conus, A Ratheesh, PD McGorry, SM Cotton
BackgroundLithium and quetiapine are considered standard maintenance agents for bipolar disorder yet it is unclear how their efficacy compares with each other.AimsTo investigate the differential effect of lithium and quetiapine on symptoms of depression, mania, general functioning, global illness severity and quality of life in patients with recently stabilised first-episode mania.MethodMaintenance trial of patients with first-episode mania stabilised on a combination of lithium and quetiapine, subsequently randomised to lithium or quetiapine monotherapy (up to 800 mg/day) and followed up for 1 year. (Trial registration: Australian and New Zealand Clinical Trials Registry – ACTRN12607000639426.)ResultsIn total, 61 individuals were randomised. Within mixed-model repeated measures analyses, significant omnibus treatment × visit interactions were observed for measures of overall psychopathology, psychotic symptoms and functioning. Planned andpost hoccomparisons further demonstrated the superiority of lithium treatment over quetiapine.ConclusionsIn people with first-episode mania treated with a combination of lithium and quetiapine, continuation treatment with lithium rather than quetiapine is superior in terms of mean levels of symptoms during a 1-year evolution.

History

Journal

British Journal of Psychiatry

Volume

210

Pagination

413-421

Location

England

ISSN

0007-1250

eISSN

1472-1465

Language

English

Publication classification

C Journal article, C1 Refereed article in a scholarly journal

Copyright notice

The Royal College of Psychiatrists 2017

Issue

6

Publisher

ROYAL COLLEGE OF PSYCHIATRISTS