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.
| Original language | English |
|---|---|
| Journal | The British journal of psychiatry : the journal of mental science |
| Volume | 205 |
| Issue number | 3 |
| Pages (from-to) | 214-20 |
| Number of pages | 7 |
| ISSN | 0007-1250 |
| DOIs | |
| Publication status | Published - 1 Sept 2014 |