Korean J Biol Psychiatry.  2016 Nov;23(4):185-192. 10.0000/kjbp.2016.23.4.185.

Long-Term Treatment Response to Lithium and Valproate in Patients with Bipolar 1 Disorder Treated More Than 2 Years : A Retrospective Study

• Ahn SW
• Yang SY
• Choi Y
• Hong KS

• KMID: 2361595
• DOI: http://doi.org/10.0000/kjbp.2016.23.4.185

Abstract

OBJECTIVES
Treatment response of bipolar disorders (BDs) to long-term mood stabilizers maintenance has not been well explored because of complicated clinical and treatment courses. This study aims at investigating long-term clinical response of BDs to lithium and/or valproate in a naturalistic setting of a tertiary-care university-affiliated hospital.
METHODS
Subjects were 65 patients with bipolar I (BD-I) disorders who had been treated with lithium and/or valproate for more than two years at single bipolar disorder clinic. Long-term response to the best treatment based on treatment algorithms and the current clinical standard of care was retrospectively evaluated using the Alda Scale and the Clinical Global Impression Scale for use in bipolar illness (CGI-BP). Patients were classified into full responder and partial/non responder groups based on the total score of the Alda Scale with the cut-off score generated from the frequentist mixture analysis of the authors' previous study.
RESULTS
The mean duration of treatment with the index medication was 69.2 months. Baseline demographic and clinical characteristics were not different among three mood stabilizer groups (valproate, lithium, and combination groups). Twenty-one subjects were classified into full responder group (32.3%). Treatment response assessed by the Alda Scale and CGI-BP scores was not different between lithium and valproate groups. The Alda Scale scores were well correlated with the CGI-BP scores (p < 0.05).
CONCLUSIONS
One third of the patients showed a full response to the long-term lithium and/or valproate treatment in BD-I. The degree of response was similar between lithium and valproate groups.

Keyword

Bipolar disorder; Long-term treatment; Response; Lithium; Valproate

MeSH Terms

Bipolar Disorder
Humans
Lithium*
Retrospective Studies*
Standard of Care
Valproic Acid*
Lithium
Valproic Acid