Valproate and lithium as maintenance therapy (2) Authors: Solomon DA, et al. Title: A pilot study of lithium carbonate plus divalproex sodium for the continuation and maintenance treatment of patients with bipolar I disorder. Reference: J Clin Psychiatry 1997;58:95-9. Purpose: To compare the efficacy of lithium and valproate in combination with lithium alone for the maintenance of bipolar disorder. Study design: Prospective, randomized, single-blinded trial. Follow up: 1 year. Patients: 12 patients (5 valproate and lithium in combination, 7 lithium). Treatment: Divalproex at serum level of 50–125 mcg/mL and lithium at serum level of 0.8–1.0 mmol/L. Results: Patients receiving combination therapy were significantly less likely to suffer a relapse or recurrence, but significantly more likely to suffer side effects (moderate or severe).
