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.