Lithium: Still best med for preventing bipolar relapse

I was on Lithium for about 10 years, and I do have to admit that it stabilized my moods for the most part.  Strangely though, when I changed psychiatrists, he did some tests and explained my lithium level was at a “toxic level”, and suggested I lower this medication, then slowly started to wean me off.  I am completely off Lithium now, didn’t seem to affect me at all, but I still remain on another mood stabilizer.  (I don’t miss the dry mouth and heat/sun problems that are side effects of Lithium).

This article on ( VIENNA — Naturalistic studies may reveal outcomes that randomized clinical trials miss. After hospital discharge, a 4-year, naturalistic follow-up of patients with bipolar disorder (BP) shows that even with prophylactic medication, relapse rates are high and are correlated with alcohol use, psychiatric comorbidities, life events, and the type of maintenance medication used.

“If you look into naturalistic studies over 4 or 5 years, then you can see that the relapse rate goes on, and far more patients have relapses…75% have relapses in spite of medication,” compared with 50% in clinical trials, said study investigator Christian Simhandl, MD, PhD, of the Bipolar Center Wiener Neustadt, in Vienna, Austria.

Those data, from a meta-analysis of observational, naturalistic studies of 1375 BP I and BP II patients, showed a 50% relapse rate at just over 1 year.

The results were presented here at the European Psychiatric Association (EPA) 23rd Congress.

Beginning in 2000, the researchers recruited consecutively admitted BP I and BP II patients (158 BP I, 142 BP II) after the patients were discharged from a community psychiatric hospital.

In this naturalistic setting, there was no specified study drug, and treatment was at the discretion of the physician. Each patient was followed yearly for 4 years between 2000 and 2008. Follow-up included personal or telephone interviews and reviews of hospital and outpatient charts.

Within 4 years, 204 (68%) patients relapsed, at a mean of 208 ± 356.2 days. Relapse began within the first couple of months after hospital discharge and correlated with the type of index episode (P < .001) (Table). Kaplan-Meier curves showed that maintenance therapy with lithium (n = 49) prevented relapse longer than therapy with other mood stabilizers (n = 250). Half of the patients receiving lithium had a first relapse between 1300 and 1400 days vs slightly less than 400 days with the other drugs (P = .002).

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2 thoughts on “Lithium: Still best med for preventing bipolar relapse

  1. booguloo says:

    High blood pressure sense the heart surgery and lithium full of salt, so i’m using Lamotrigine (Lamictal) and benztropine mesylate for tremors. Working out well.


    • cherished79 says:

      I have been on Lamictal for many years and so far so good. Was on it the same time as Lithium, went off Lithium and only taking Lamictal and it seems it’s doing it’s job. Thanks for commenting.


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