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Lithium Beats Valproate for Long-Term Bipolar Therapy

Combined treatment or monotherapy with lithium helps prevent relapse, study finds

WEDNESDAY, Dec. 23 (HealthDay News) -- People with bipolar I disorder will do best over the long term with lithium treatment alone or a combination of lithium and valproate compared to valproate alone, new research suggests.

Patients who underwent the lithium or lithium/valproate treatments were less likely to relapse regardless of how severe their conditions were at the beginning of treatment, the study authors reported in the Dec. 22 online edition of The Lancet.

But the researchers couldn't say if the combined treatment is better or worse than lithium alone.

People with bipolar disorder have trouble regulating their moods and can swing between highs and lows. In most cases, patients have illness that is chronic or recurs over time. Doctors often prescribe combinations of drugs for these patients after single drugs fail to work, according to background information in a news release about the study.

The new study looked at 330 patients aged 16 and older with bipolar I disorder. The study participants lived in several countries, including the United States, and were randomly assigned to receive lithium, valproate or a combination of both drugs. They were followed for up to two years.

The results show that "for people with bipolar I disorder for whom long-term therapy is clinically indicated, combination therapy with lithium plus valproate is more likely to prevent relapse than is monotherapy with valproate. The 41 percent relative benefit is irrespective of baseline severity of illness, is maintained for up to two years, and is most apparent in prevention of manic relapse," the researchers concluded.

More information

The U.S. National Institute of Mental Health has more on bipolar disorder.

-- Randy Dotinga

SOURCE: The Lancet, news release, Dec. 22, 2009

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