Individuals treated with lithium for bipolar disorder had the lowest risk of rehospitalisation, according to a study from Karolinska Institutet in Sweden published in JAMA Psychiatry. Long-acting injections of antipsychotics were also found to be more effective at reducing the risk of rehospitalisation compared with their oral counterparts.
Bipolar disorder is characterised by alternating periods of depression and elevated mood (mania), and is usually treated either with mood stabilising or antipsychotic drugs. Lithium is considered to be the most effective mood stabiliser, but only a few studies have been conducted comparing the long-term effects of different drugs in bipolar disorder.
In order to determine which treatment is most effective, researchers at Karolinska Institutet compared the risk of re-admission to hospital in more than 18,000 patients in Finland who had previously been hospitalised for bipolar disorder. Each patient was used as their own control and compared during periods with and without treatment.
"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", says Jari Tiihonen, specialist doctor and professor at Karolinska Institutet's Department of Clinical Neuroscience.
The research was funded by the Finnish Ministry of Social Affairs and Health. No company has financed this particular study, but several of the authors are associated with and have previously received funding/fees from pharmaceutical companies in different contexts. Two of the authors are employed by the contract research organisation EPID Research. The scientific article provides more detailed information about potential conflicts of interest.