This systematic review indicates that lithium is more effective than placebo as a treatment for acute mania but increases the risk for somnolence and tremor .
Limited evidence suggests little or no difference between lithium and other mood stabilisers ( valproate , carbamazepine ) or antipsychotics ( risperidone , quetiapine , haloperidol ) .
Olanzapine may be an exception , as it is probably slightly more effective than lithium .
There is uncertain evidence that risperidone may also be more effective than lithium .
Lithium is probably more effective at treating acute mania than topiramate .
When compared to placebo , lithium was more likely to cause adverse events .
More , rigorously design ed , large-scale studies are needed to definitively conclude if lithium is superior to other interventions in treating acute mania
BACKGROUND Bipolar disorder is a common condition associated with high morbidity ; developing efficacious , safe treatments is therefore essential .
Lithium is an effective maintenance treatment for bipolar disorder .
It acts as mood stabiliser and reduces the risk of suicide .
However , evidence assessing the efficacy of lithium in the treatment of acute mania is less robust .
Current evidence -based guidelines cite multiple anti-dopaminergic and mood-stabilising agents as initial treatments : more definite evidence is needed to decide if lithium should be the first-line therapy .
OBJECTIVES 1 .
To assess the effects of lithium in comparison with placebo or other active treatment in alleviating the acute symptoms of a manic or mixed episode in people with bipolar disorder.2 .
To review the acceptability and tolerability of treatment with lithium in comparison with placebo or other active treatments in alleviating the acute symptoms of a manic or mixed episode in people with bipolar disorder .
Frequency of hospitalisations and inpatient care costs of manic episodes
Abstract Background : Bipolar disorder is a chronic illness that may involve multiple relapses and result in substantial psychosocial impairment . However , very few recent studies have investigated the economic burden of the disease . Objective : To assess the frequency of hospitalisation and the inpatient care costs associated with manic episodes in patients with bipolar I disorder in France . Method : A cost-of-illness study was conducted based on available data using a hospital payer perspective . The lifetime prevalence of manic episodes was estimated from published epidemiological data using a r and om-effects meta- analysis . Data were obtained by a computerised literature search using the main scientific and medical data bases . Additional epidemiological references were identified from published studies and textbooks . Data on frequency of hospitalisation and length of stay were collected from a large psychiatric university hospital . Data on unit costs for inpatient care were obtained from the accounting system of the largest hospital group in Paris , France for the year 1999 . Results : Extrapolating from international data on the average prevalence of bipolar I disorder , the proportion of rapid cycling patients and the average cycle duration , we estimated the annual number of manic episodes in patients with bipolar I disorder to be around 265 000 in France . Based on hospital data in Paris , the proportion of manic episodes that require hospitalisation was estimated to be around 63 % . The average length of stay was 32.4 days and the hospitalisation-related costs were estimated to be around 8.8 billion French francs ( € 1.3 billion ) [ 1999 values ] . Conclusion : Our study highlights the lack of medical and economic data on the frequency and hospitalisation-related costs of manic episodes in patients with bipolar I disorder in France . As the lifetime prevalence of bipolar I disorder may be as high as 3 % among adults , further studies are required in order to provide representative national data and to allow economic evaluations of costs related to bipolar I disorder in France
This systematic review indicates that lithium is more effective than placebo as a treatment for acute mania but increases the risk for somnolence and tremor .
Limited evidence suggests little or no difference between lithium and other mood stabilisers ( valproate , carbamazepine ) or antipsychotics ( risperidone , quetiapine , haloperidol ) .
Olanzapine may be an exception , as it is probably slightly more effective than lithium .
There is uncertain evidence that risperidone may also be more effective than lithium .
Lithium is probably more effective at treating acute mania than topiramate .
When compared to placebo , lithium was more likely to cause adverse events .
More , rigorously design ed , large-scale studies are needed to definitively conclude if lithium is superior to other interventions in treating acute mania
BACKGROUND Bipolar disorder is a common condition associated with high morbidity ; developing efficacious , safe treatments is therefore essential .
Lithium is an effective maintenance treatment for bipolar disorder .
It acts as mood stabiliser and reduces the risk of suicide .
However , evidence assessing the efficacy of lithium in the treatment of acute mania is less robust .
Current evidence -based guidelines cite multiple anti-dopaminergic and mood-stabilising agents as initial treatments : more definite evidence is needed to decide if lithium should be the first-line therapy .
OBJECTIVES 1 .
To assess the effects of lithium in comparison with placebo or other active treatment in alleviating the acute symptoms of a manic or mixed episode in people with bipolar disorder.2 .
To review the acceptability and tolerability of treatment with lithium in comparison with placebo or other active treatments in alleviating the acute symptoms of a manic or mixed episode in people with bipolar disorder .