Quetiapine v. lithium in the maintenance phase following a first episode of mania

Randomised controlled trial

Michael Berk, Rothanthi Daglas, Orwa Dandash, Murat Yücel, Lisa Henry, Karen Hallam, Craig Macneil, Melissa K Hasty, Christos Pantelis, Brendan P. Murphy, Linda F Kader, Saji Damodaran, Michael T.H. Wong, Philippe Conus, Aswin Ratheesh, Patrick D McGorry, Sue M. Cotton

Research output: Contribution to journalArticleResearchpeer-review

19 Citations (Scopus)

Abstract

Background 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 treatment6visit 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.

Original languageEnglish
Pages (from-to)413-421
Number of pages9
JournalBritish Journal of Psychiatry
Volume210
Issue number6
DOIs
Publication statusPublished - 1 Jun 2017

Cite this

Berk, Michael ; Daglas, Rothanthi ; Dandash, Orwa ; Yücel, Murat ; Henry, Lisa ; Hallam, Karen ; Macneil, Craig ; Hasty, Melissa K ; Pantelis, Christos ; Murphy, Brendan P. ; Kader, Linda F ; Damodaran, Saji ; Wong, Michael T.H. ; Conus, Philippe ; Ratheesh, Aswin ; McGorry, Patrick D ; Cotton, Sue M. / Quetiapine v. lithium in the maintenance phase following a first episode of mania : Randomised controlled trial. In: British Journal of Psychiatry. 2017 ; Vol. 210, No. 6. pp. 413-421.
@article{01a5bd6542534029b946d68718aed5b0,
title = "Quetiapine v. lithium in the maintenance phase following a first episode of mania: Randomised controlled trial",
abstract = "Background 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 treatment6visit 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.",
author = "Michael Berk and Rothanthi Daglas and Orwa Dandash and Murat Y{\"u}cel and Lisa Henry and Karen Hallam and Craig Macneil and Hasty, {Melissa K} and Christos Pantelis and Murphy, {Brendan P.} and Kader, {Linda F} and Saji Damodaran and Wong, {Michael T.H.} and Philippe Conus and Aswin Ratheesh and McGorry, {Patrick D} and Cotton, {Sue M.}",
year = "2017",
month = "6",
day = "1",
doi = "10.1192/bjp.bp.116.186833",
language = "English",
volume = "210",
pages = "413--421",
journal = "British Journal of Psychiatry",
issn = "0007-1250",
publisher = "Royal College of Psychiatrists",
number = "6",

}

Berk, M, Daglas, R, Dandash, O, Yücel, M, Henry, L, Hallam, K, Macneil, C, Hasty, MK, Pantelis, C, Murphy, BP, Kader, LF, Damodaran, S, Wong, MTH, Conus, P, Ratheesh, A, McGorry, PD & Cotton, SM 2017, 'Quetiapine v. lithium in the maintenance phase following a first episode of mania: Randomised controlled trial', British Journal of Psychiatry, vol. 210, no. 6, pp. 413-421. https://doi.org/10.1192/bjp.bp.116.186833

Quetiapine v. lithium in the maintenance phase following a first episode of mania : Randomised controlled trial. / Berk, Michael; Daglas, Rothanthi; Dandash, Orwa; Yücel, Murat; Henry, Lisa; Hallam, Karen; Macneil, Craig; Hasty, Melissa K; Pantelis, Christos; Murphy, Brendan P.; Kader, Linda F; Damodaran, Saji; Wong, Michael T.H.; Conus, Philippe; Ratheesh, Aswin; McGorry, Patrick D; Cotton, Sue M.

In: British Journal of Psychiatry, Vol. 210, No. 6, 01.06.2017, p. 413-421.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Quetiapine v. lithium in the maintenance phase following a first episode of mania

T2 - Randomised controlled trial

AU - Berk, Michael

AU - Daglas, Rothanthi

AU - Dandash, Orwa

AU - Yücel, Murat

AU - Henry, Lisa

AU - Hallam, Karen

AU - Macneil, Craig

AU - Hasty, Melissa K

AU - Pantelis, Christos

AU - Murphy, Brendan P.

AU - Kader, Linda F

AU - Damodaran, Saji

AU - Wong, Michael T.H.

AU - Conus, Philippe

AU - Ratheesh, Aswin

AU - McGorry, Patrick D

AU - Cotton, Sue M.

PY - 2017/6/1

Y1 - 2017/6/1

N2 - Background 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 treatment6visit 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.

AB - Background 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 treatment6visit 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.

UR - http://www.scopus.com/inward/record.url?scp=85020123073&partnerID=8YFLogxK

U2 - 10.1192/bjp.bp.116.186833

DO - 10.1192/bjp.bp.116.186833

M3 - Article

VL - 210

SP - 413

EP - 421

JO - British Journal of Psychiatry

JF - British Journal of Psychiatry

SN - 0007-1250

IS - 6

ER -