Carbamazepine vs lithium in bipolar maintenance Authors: Kleindienst N and Greil W. Title: Inter-episodic morbidity and dropout under carbamazepine and lithium in the maintenance treatment of bipolar disorder. Reference: Psychol Med 2002;32:493–501. Purpose: To determine inter-episodic morbidity and drop-out rate during mood-stabilizing treatment. Study design: Sub-analysis of a randomized, controlled trial (MAP trial). Follow up: 2.5 years. Patients: 171 bipolar patients (86 lithium, 85 carbamazepine). Treatment: Average doses from month 2: Lithium 26.8 + 6.76 mmol/day (serum level 0.61 + 0.12 mmol/L), carbamazepine 635 + 190 mg/day (serum level 6.12 + 1.27 mcg/mL). Results: Rates of rehospitalization were similar with both treatments. The percentage of patients with a good clinical response was significantly higher with lithium compared with carbamazepine (40% versus 24%) and there was a significant difference in the level of treatment response between groups (p = 0.022). In the lithium group, inter-episodic morbidity without rehospitalization was significantly decreased. For both treatments, significant depressive symptoms remained between mood episodes.
Multicentre study of long-term treatment of Affective and schizoaffective Psychoses
