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.
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | The British journal of psychiatry : the journal of mental science |
| Vol/bind | 205 |
| Udgave nummer | 3 |
| Sider (fra-til) | 214-20 |
| Antal sider | 7 |
| ISSN | 0007-1250 |
| DOI | |
| Status | Udgivet - 1 sep. 2014 |