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.
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