According to a study by the Swedish Karolinska Institute, people with bipolar disorder treated with lithium have a lower risk of re-hospitalization than with any other treatment.
Bipolar disorder is characterized by alternating episodes of depression and mania. According to the World Health Organization, this disease is the sixth most common cause of disability in the world. Lithium is considered the most effective mood stabilizer treatment, but only a few studies compare the long-term effects of different treatments.
Researchers at the Karolinska Institute in Sweden have therefore analyzed the fate of 18,000 Finnish patients, already hospitalized for bipolar disorder, depending on the treatment received and by comparing the rates of rehospitalization of patients. Their results were published in JAMA psychiatry February 28, 2018.
The percentage of readmissions differs depending on the treatment
The follow-up of the patients lasted on average more than 7 years. Within the cohort (9,558 women and 8,460 men, on average 46 years old) 9,721 patients, or 54%, had at least one rehospitalization in psychiatry.
According to the study, lithium is the treatment associated with the lowest risk of rehospitalization, with a risk reduction of about 30% compared to no treatment. Injections of long-acting antipsychotics (risperidone, perphenazine) are also effective and also reduce the risk of rehospitalization by 30%, but this compared to their oral equivalents.
The most frequently prescribed antipsychotic drug for bipolar disorder, quetiapine, which is given as tablets, reduced the risk by only 7%.
Under-prescription of lithium to be reassessed
“The prescription of lithium has declined steadily in recent years, but our results show that lithium should remain the first line of treatment for patients with bipolar disorder.
Long-acting antipsychotic injections could offer a safe and effective alternative for patients in whom lithium is not suitable, ”explains one of the study’s authors, Jari Tiihonen, professor in the department of clinical neurosciences at the Karolinska Institute.
The authors of the study state that “although more research is needed to support this idea, injections of long-acting antipsychotics may be a safe and effective option for the prevention of relapse in bipolar disorder in patients with which lithium is not suitable “.
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