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 language | English |
|---|---|
| Pages (from-to) | 413-421 |
| Number of pages | 9 |
| Journal | British Journal of Psychiatry |
| Volume | 210 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - 1 Jun 2017 |
Cite this
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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 journal › Article › Research › peer-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 -