Authors: Prien RF, et al.
Title: Lithium carbonate and imipramine in prevention of affective episodes – a comparison in recurrent affective illness.
Reference: Arch Gen Psychiatry 1973;29:420-5.
Purpose: To compare the efficacy of lithium and imipramine with placebo in the relapse of bipolar (and unipolar depression) disorder following a depressive episode.
Study design: Randomized, placebo-controlled trial.
Follow up: Up to 2 years.
Patients: 44 patients (18 Lithium, 13 imipramine, and 13 placebo).
Treatment: Lithium titrated to a median serum level of 0.8 mEq/L or imipramine 50–200 mg/day.
Results: Lithium was significantly more effective than placebo or imipramine at preventing relapses. There was a relatively high incidence of manic episodes in the imipramine group (affective switching).