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Study of Bipolar Disorder Drugs Finds Lithium is Still Gold Standard

Study of Bipolar Disorder Drugs Finds Lithium is Still Gold Standard

A new Swedish study published in the Journal of the American Medical Association finds that lithium remains the gold standard for helping individuals with bipolar disorder avoid hospitalization. The new study investigated the long-term effects of different drugs for bipolar disorder.

Long-acting injections of antipsychotics were also effective, reducing the risk of rehospitalization by 30 percent compared with their oral counterparts.

Researchers at Karolinska Institutet compared the risk of re-admission to hospital in more than 18,000 patients in Finland who had previously been hospitalized for bipolar disorder. Each patient was used as his or her own control and compared during periods with and without treatment.

Bipolar disorder is characterized by alternating periods of depression and elevated mood (mania), and is usually treated either with mood stabilizing or antipsychotic drugs.

Lithium is considered to be the most effective mood stabilizer, but only a few studies have been conducted comparing the long-term impact of different drugs in bipolar disorder.

Investigators discovered that for an average follow-up time of more than seven years, lithium treatment was associated with the lowest risk of rehospitalization in mental or physical disease.

The medication achieved a risk reduction of about 30 percent compared with no treatment at all. Long-acting injections of antipsychotic drugs were also effective.

The risk of re-admission was around 30 percent lower if patients were treated with long-acting injections compared to their receiving the same antipsychotic medication but orally. The most commonly prescribed antipsychotic drug for bipolar disorder, quetiapine (Seroquel), which is given in tablet form, reduced the risk by only seven percent.

“The prescription of lithium has decreased steadily in recent years, but our results show that lithium should remain the first line of treatment for patients with bipolar disorder. Long-acting injections might offer a safe, effective option for patients for whom lithium is not suitable,” said Dr. Jari Tiihonen, a physician and professor at Karolinska Institutet’s Department of Clinical Neuroscience.

Source: Karolinska Institute/EurekAlert

Study of Bipolar Disorder Drugs Finds Lithium is Still Gold Standard

Rick Nauert PhD

Rick Nauert, PhDDr. Rick Nauert has over 25 years experience in clinical, administrative and academic healthcare. He is currently an associate professor for Rocky Mountain University of Health Professionals doctoral program in health promotion and wellness. Dr. Nauert began his career as a clinical physical therapist and served as a regional manager for a publicly traded multidisciplinary rehabilitation agency for 12 years. He has masters degrees in health-fitness management and healthcare administration and a doctoral degree from The University of Texas at Austin focused on health care informatics, health administration, health education and health policy. His research efforts included the area of telehealth with a specialty in disease management.

APA Reference
Nauert PhD, R. (2018). Study of Bipolar Disorder Drugs Finds Lithium is Still Gold Standard. Psych Central. Retrieved on September 28, 2020, from
Scientifically Reviewed
Last updated: 8 Aug 2018 (Originally: 1 Mar 2018)
Last reviewed: By a member of our scientific advisory board on 8 Aug 2018
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