Lars Vedel Kessing1, Eleni Vradi1, Per Kragh Andersen1. 1. Lars Vedel Kessing, MD, DMSc, Psychiatric Center Copenhagen, Department O, and Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Eleni Vradi, MSc, Per Kragh Andersen, MSc, PhD, DMSc, Department of Biostatistics, University of Copenhagen, Denmark.
Abstract
BACKGROUND: No study has investigated when preventive treatment with lithium should be initiated in bipolar disorder. AIMS: To compare response rates among patients with bipolar disorder starting treatment with lithium early v. late. METHOD: Nationwide registers were used to identify all patients with a diagnosis of bipolar disorder in psychiatric hospital settings who were prescribed lithium during the period 1995-2012 in Denmark (n = 4714). Lithium responders were defined as patients who, following a stabilisation lithium start-up period of 6 months, continued lithium monotherapy without being admitted to hospital. Early v. late intervention was defined in two ways: (a) start of lithium following first contact; and (b) start of lithium following a diagnosis of a single manic/mixed episode. RESULTS: Regardless of the definition used, patients who started lithium early had significantly decreased rates of non-response to lithium compared with the rate for patients starting lithium later (adjusted analyses: first v. later contact: P<0.0001; hazard ratio (HR) = 0.87, 95% CI 0.76-0.91; single manic/mixed episode v. bipolar disorder: P<0.0001; HR = 0.75, 95% CI 0.67-0.84). CONCLUSIONS: Starting lithium treatment early following first psychiatric contact or a single manic/mixed episode is associated with increased probability of lithium response. Royal College of Psychiatrists.
BACKGROUND: No study has investigated when preventive treatment with lithium should be initiated in bipolar disorder. AIMS: To compare response rates among patients with bipolar disorder starting treatment with lithium early v. late. METHOD: Nationwide registers were used to identify all patients with a diagnosis of bipolar disorder in psychiatric hospital settings who were prescribed lithium during the period 1995-2012 in Denmark (n = 4714). Lithium responders were defined as patients who, following a stabilisation lithium start-up period of 6 months, continued lithium monotherapy without being admitted to hospital. Early v. late intervention was defined in two ways: (a) start of lithium following first contact; and (b) start of lithium following a diagnosis of a single manic/mixed episode. RESULTS: Regardless of the definition used, patients who started lithium early had significantly decreased rates of non-response to lithium compared with the rate for patients starting lithium later (adjusted analyses: first v. later contact: P<0.0001; hazard ratio (HR) = 0.87, 95% CI 0.76-0.91; single manic/mixed episode v. bipolar disorder: P<0.0001; HR = 0.75, 95% CI 0.67-0.84). CONCLUSIONS: Starting lithium treatment early following first psychiatric contact or a single manic/mixed episode is associated with increased probability of lithium response. Royal College of Psychiatrists.
Authors: Kamilla W. Miskowiak; Julie L. Forman; Maj Vinberg; Hartwig R. Siebner; Lars V. Kessing; Julian Macoveanu Journal: J Psychiatry Neurosci Date: 2020-05-01 Impact factor: 6.186
Authors: Philipp S Ritter; Felix Bermpohl; Oliver Gruber; Martin Hautzinger; Andreas Jansen; Georg Juckel; Tilo Kircher; Martin Lambert; Christoph Mulert; Andrea Pfennig; Andreas Reif; Otto Rienhoff; Thomas G Schulze; Emanuel Severus; Thomas Stamm; Michael Bauer Journal: Int J Bipolar Disord Date: 2016-11-21
Authors: G M Goodwin; P M Haddad; I N Ferrier; J K Aronson; Trh Barnes; A Cipriani; D R Coghill; S Fazel; J R Geddes; H Grunze; E A Holmes; O Howes; S Hudson; N Hunt; I Jones; I C Macmillan; H McAllister-Williams; D R Miklowitz; R Morriss; M Munafò; C Paton; B J Saharkian; Kea Saunders; Jma Sinclair; D Taylor; E Vieta; A H Young Journal: J Psychopharmacol Date: 2016-03-15 Impact factor: 4.153
Authors: Julia Martini; Karolina Leopold; Steffi Pfeiffer; Christina Berndt; Anne Boehme; Veit Roessner; Paolo Fusar-Poli; Allan H Young; Christoph U Correll; Michael Bauer; Andrea Pfennig Journal: Int J Bipolar Disord Date: 2021-07-02