Am J Psychiatry 155:638-645, May 1998
© 1998 American Psychiatric Association
Lithium Maintenance Treatment of Depression and Mania in Bipolar I and Bipolar II Disorders
Leonardo Tondo, M.D.,
Ross J. Baldessarini, M.D.,
John Hennen, Ph.D., and
Gianfranco Floris, M.D.
OBJECTIVE: Effects of long-term lithium treatment for depressive and manic phases of type I and type II bipolar disorders were compared. METHOD: Clinical research records of 317 patients with DSM-IV-defined bipolar disorder (188 with type I and 129 with type II) were analyzed for frequency and duration of affective episodes and hospitalizations before (mean=8.38 years) versus during (mean=6.35 years) lithium maintenance treatment. Treatment effects were also assessed by survival analysis of interepisode intervals and by multivariate regression testing for factors associated with response to treatment. RESULTS: Bipolar I and bipolar II patients were ill before treatment a similar percentage of time, but the subtype distinction was supported descriptively. Lithium had superior benefits in type II patients, with significantly greater reduction of episodes per year and of the percentage of time ill. Reduction of depressive morbidity was similarly strong in both diagnostic types. During treatment, bipolar II patients had 5.9-fold longer interepisode intervals and were twice as likely as type I patients to have no new episodes. Starting lithium maintenance earlier predicted greater improvement. CONCLUSIONS: Lithium maintenance yielded striking long-term reductions of depressive as well as manic morbidity in both bipolar disorder subtypes, with greater overall benefits in type II patients and with earlier treatment.
This article has been cited by other articles:
|
|
|
|
 
A. Winstock, T. Lea, and J. Copeland
Lithium carbonate in the management of cannabis withdrawal in humans: an open-label study
J Psychopharmacol,
January 1, 2009;
23(1):
84 - 93.
[Abstract]
[PDF]
|
|
|
|
|
|
|
C. D. Schneck, D. J. Miklowitz, J. R. Calabrese, M. H. Allen, M. R. Thomas, S. R. Wisniewski, S. Miyahara, M. D. Shelton, T. A. Ketter, J. F. Goldberg, et al.
Phenomenology of Rapid-Cycling Bipolar Disorder: Data From the First 500 Participants in the Systematic Treatment Enhancement Program
Am J Psychiatry,
October 1, 2004;
161(10):
1902 - 1908.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. J. Baldessarini and L. Tondo
Suicide Risk and Treatments for Patients With Bipolar Disorder
JAMA,
September 17, 2003;
290(11):
1517 - 1519.
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. J. Miklowitz, E. L. George, J. A. Richards, T. L. Simoneau, and R. L. Suddath
A Randomized Study of Family-Focused Psychoeducation and Pharmacotherapy in the Outpatient Management of Bipolar Disorder
Arch Gen Psychiatry,
September 1, 2003;
60(9):
904 - 912.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. H. Rapaport and D. J. Hales
Relapse Prevention and Bipolar Disorder: A Focus on Bipolar Depression
Focus,
January 1, 2003;
1(1):
15 - 31.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Blanco, G. Laje, M. Olfson, S. C. Marcus, and H. A. Pincus
Trends in the Treatment of Bipolar Disorder by Outpatient Psychiatrists
Am J Psychiatry,
June 1, 2002;
159(6):
1005 - 1010.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. J. BALDESSARINI and L. TONDO
Long-Term Lithium for Bipolar Disorder
Am J Psychiatry,
October 1, 2001;
158(10):
1740 - 1740.
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. TONDO, R. J. BALDESSARINI, and G. FLORIS
Long-term clinical effectiveness of lithium maintenance treatment in types I and II bipolar disorders
The British Journal of Psychiatry,
June 1, 2001;
178
(41):
s184 - s190.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. C. Viguera, L. Tondo, and R. J. Baldessarini
Sex Differences in Response to Lithium Treatment
Am J Psychiatry,
September 1, 2000;
157(9):
1509 - 1511.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
R. J. Baldessarini, M. Tohen, and L. Tondo
Maintenance Treatment in Bipolar Disorder
Arch Gen Psychiatry,
May 1, 2000;
57(5):
490 - 492.
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. J. Baldessarini and L. Tondo
Does Lithium Treatment Still Work?: Evidence of Stable Responses Over Three Decades
Arch Gen Psychiatry,
February 1, 2000;
57(2):
187 - 190.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. J. BALDESSARINI, L. TONDO, and J. HENNEN
Treatment Delays in Bipolar Disorders
Am J Psychiatry,
May 1, 1999;
156(5):
811a - 811.
[Full Text]
|
|
|
|
|
|
|
L. Tondo and R. J. Baldessarini
Rapid Cycling in Women and Men With Bipolar Manic-Depressive Disorders
Am J Psychiatry,
October 1, 1998;
155(10):
1434 - 1436.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
New Studies on an Old Drug: Lithium Revisited
Journal Watch Psychiatry,
July 1, 1998;
1998(701):
5 - 5.
[Full Text]
|
|
|
Get information about faster international access.
Privacy Policy
Copyright © 1998
American Psychiatric Association.
All rights reserved.
Home
| Search
| Current Issue
| Past Issues
| Subscribe
| All APPI Journals
| Help
| Contact Us
|
