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 |  |  |  |  | | | Lithium and imipramine in affective episodes 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).
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