berk-quetiapinevlithium-2017.pdf (531.74 kB)
Quetiapine v. lithium in the maintenance phase following a first episode of mania: randomised controlled trial
journal contribution
posted on 2017-06-01, 00:00 authored by Michael BerkMichael Berk, R Daglas, O Dandash, M Yücel, L Henry, Karen Hallam, C Macneil, M Hasty, C Pantelis, B P Murphy, L Kader, S Damodaran, M T H Wong, P Conus, A Ratheesh, P D McGorry, S M CottonBackground
Lithium and quetiapine are considered standard maintenance agents for bipolar disorder yet it is unclear how their efficacy compares with each other.
Aims
To 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.
Method
Maintenance 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.)
Results
In 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 and post hoc comparisons further demonstrated the superiority of lithium treatment over quetiapine.
Conclusions
In 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.
Lithium and quetiapine are considered standard maintenance agents for bipolar disorder yet it is unclear how their efficacy compares with each other.
Aims
To 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.
Method
Maintenance 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.)
Results
In 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 and post hoc comparisons further demonstrated the superiority of lithium treatment over quetiapine.
Conclusions
In 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 psychiatryVolume
210Issue
6Pagination
413 - 421Publisher
Royal College of PsychiatristsLocation
London, United KingdomPublisher DOI
eISSN
1472-1465Language
engPublication classification
C Journal article; C1 Refereed article in a scholarly journalCopyright notice
The Royal College of Psychiatrists 2017Usage metrics
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