Starting lithium prophylaxis early v. late in bipolar disorder
Research output: Contribution to journal › Journal article › Research › peer-review
Standard
Starting lithium prophylaxis early v. late in bipolar disorder. / Kessing, Lars Vedel; Vradi, Eleni; Andersen, Per Kragh.
In: The British journal of psychiatry : the journal of mental science, Vol. 205, No. 3, 09.2014, p. 214-20.Research output: Contribution to journal › Journal article › Research › peer-review
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - Starting lithium prophylaxis early v. late in bipolar disorder
AU - Kessing, Lars Vedel
AU - Vradi, Eleni
AU - Andersen, Per Kragh
N1 - Royal College of Psychiatrists.
PY - 2014/9
Y1 - 2014/9
N2 - 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.
AB - 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.
U2 - 10.1192/bjp.bp.113.142802
DO - 10.1192/bjp.bp.113.142802
M3 - Journal article
C2 - 25012681
VL - 205
SP - 214
EP - 220
JO - The Journal of mental science
JF - The Journal of mental science
SN - 0960-5371
IS - 3
ER -
ID: 135436878