Differential Efficacy of Lithium and Carbamazepine in the Prophylaxis of Bipolar Disorder: Results of the MAP Study
Abstract
In a randomized clinical trial with an observation period of 2.5 years, the differential efficacy of lithium versus carbamazepine was compared in 171 bipolar patients (DSM-IV). In order to investigate the efficacy of the two drugs in clearly defined subsamples, a series of subgroup analyses was carried out. First, patients with a bipolar I disorder (n = 114) were analyzed separately. In these patients, lithium was superior to carbamazepine. In contrast, carbamazepine was at least equally as efficacious as lithium in the subsample of patients with bipolar II disorder or bipolar disorder not otherwise specified (n = 57). In a second analysis on differential efficacy, the whole sample was subdivided into a classical subgroup (bipolar I patients without mood-incongruent delusions and without comorbidity; n = 67) and a nonclassical subgroup including all other patients (n = 104). Classical bipolar patients had a significantly lower hospitalization rate under lithium than under carbamazepine prophylaxis (26 vs. 62%, p = 0.012). For the nonclassical group, a tendency in favor of carbamazepine was found. In a third step, we analyzed the impact of episode sequence on differential efficacy. In a global view, the episode sequence prior to the index episode was not correlated to differential efficacy. Our results might, however, indicate that patients with an episode sequence of mania-depression-free interval responded better to lithium. Besides differential efficacy, suicidal behavior and patients’ satisfaction with treatment were investigated. Regarding suicidal behavior, a trend in favor of lithium was found. The data on patients’ satisfaction were significantly in favor of carbamazepine. In conclusion, lithium appears to be superior to carbamazepine in classical bipolar cases and might have additional impact on proneness to suicide. The distinctly larger group of patients with nonclassical features might profit more from carbamazepine which seems to be well accepted by the patients. Hence, treatment alternatives to lithium are desirable for the majority of bipolar patients.
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Clinical experience and the results of many studies suggest that response to mood stabilizers and antipsychotics is similar in bipolar II and bipolar I disorder, but there are enough exceptions to suggest this should not be taken for granted.
“while clinical experience and the results of many studies suggest that response to mood stabilizers and antipsychotics is similar in BDII and BDI, there are enough exceptions to suggest this should not be taken for granted.248, 405, 431”
From Canadian Network for Mood and Anxiety Treatments ( <scp>CANMAT</scp> ) and International Society for Bipolar Disorders ( <scp>ISBD</scp> ) 2018 guidelines for the management of patients with bipolar disorder (2018) · cites this paper as [405]
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Experimental — accuracy not yet measuredAvailable data on predictors of response come mostly from naturalistic/cohort studies and few randomized trials.
“Available data come mostly from naturalistic/cohort studies and few randomized trials.405”
From Canadian Network for Mood and Anxiety Treatments ( <scp>CANMAT</scp> ) and International Society for Bipolar Disorders ( <scp>ISBD</scp> ) 2018 guidelines for the management of patients with bipolar disorder (2018) · cites this paper as [405]
The Discussion says that several retrospective studies examined predictors of lithium response, and describes this paper's data as coming from a randomized prospective study (page numbers unavailable in our copy). It does not establish that predictor evidence comes mostly from naturalistic or cohort studies, or that randomized trials are few. (LLM, conf=0.76)
Experimental — accuracy not yet measuredIn a randomized open trial of carbamazepine versus lithium, responders to carbamazepine were more likely to have an atypical illness, bipolar II disorder or schizoaffective disorder.
“In a randomized open trial of carbamazepine versus lithium, responders to carbamazepine were more likely to have an atypical illness, BDII or schizoaffective disorder.405”
From Canadian Network for Mood and Anxiety Treatments ( <scp>CANMAT</scp> ) and International Society for Bipolar Disorders ( <scp>ISBD</scp> ) 2018 guidelines for the management of patients with bipolar disorder (2018) · cites this paper as [405]
The Discussion reports that carbamazepine’s relative efficacy increased as patients became less like the classical bipolar type. But the Bipolar I versus Bipolar II/NOS section calls those subgroup results inconclusive, and although Subjects and Methods includes schizoaffective patients, the paper does not report that schizoaffective patients were more likely to respond to carbamazepine. Page numbers are unavailable in our copy. (LLM, conf=0.87)
Experimental — accuracy not yet measuredIn a 2.5-year study in bipolar II plus bipolar disorder not otherwise specified, lithium and carbamazepine were equally effective on most outcomes, although a numerical advantage favoured carbamazepine for reducing clinical plus subclinical recurrence.
“In a 2.5‐year study in BDII + BD NOS, lithium and carbamazepine were equally effective on most outcomes, although a numerical advantage favoured carbamazepine for reducing clinical plus subclinical recurrence.405”
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Cites
Nonparametric Estimation from Incomplete Observations
Kaplan, E. L., & Meier, P. (1992) · Springer series in statistics · doi:10.1007/978-1-4612-4380-9_25 · Cited by 45,232 · see citing works
The Global Assessment Scale: A Procedure for Measuring Overall Severity of Psychiatric Disturbance
Endicott, J. (1976) · Archives of General Psychiatry · doi:10.1001/archpsyc.1976.01770060086012 · Cited by 4,982 · see citing works
Davenport, Y. B., Adland, M. L., Gold, P. W., & Goodwin, F. K. (1984) · The Lancet · doi:10.1016/s0140-6736(84)92810-1 · Cited by 2,925 · see citing works
Chi-Square Tests with One Degree of Freedom; Extensions of the Mantel- Haenszel Procedure
Mantel, N. (1963) · Journal of the American Statistical Association · doi:10.1080/01621459.1963.10500879 · Cited by 2,899 · see citing works
Bowden, C. L. (1994) · JAMA · doi:10.1001/jama.271.12.918 · Cited by 955 · see citing works
On Distribution-Free Tests for Equality of Survival Distributions
Tarone, R. E., & Ware, J. S. (1977) · Biometrika · doi:10.1093/biomet/64.1.156 · Cited by 733 · see citing works
Lithium As a Prophylactic Agent
Baastrup, P. C. (1967) · Archives of General Psychiatry · doi:10.1001/archpsyc.1967.01730200030005 · Cited by 573 · see citing works
The Prevalent Clinical Spectrum of Bipolar Disorders: Beyond DSM-IV
Akiskal, H. S. (1996) · Journal of Clinical Psychopharmacology · doi:10.1097/00004714-199604001-00002 · Cited by 535 · see citing works
Course of the Manic-Depressive Cycle and Changes Caused by Treatments
Kukopulos, A., Reginaldi, D., Laddomada, P., Floris, G., Serra, G., & Tondo, L. (2008) · Pharmacopsychiatry · doi:10.1055/s-2007-1019628 · Cited by 436 · see citing works
[Long-term treatment of depression].
Keller, M. B. (1994) · PubMed · Cited by 362 · see citing works
Outcome of Bipolar Disorder on Long-Term Treatment with Lithium
O’Connell, R. A., Mayo, J. A., Flatow, L., Cuthbertson, B. A., & O'Brien, B. E. (1991) · The British Journal of Psychiatry · doi:10.1192/bjp.159.1.123 · Cited by 332 · see citing works
Lithium versus carbamazepine in the maintenance treatment of bipolar disorders – a randomised study
Greil, W., Ludwig‐Mayerhofer, W., Erazo, N., Schoechlin, C., Schmidt, S., Engel, R. R., Czernik, A., Giedke, H., Müller-Oerlinghausen, B., Osterheider, M., et al. (1997) · Journal of Affective Disorders · doi:10.1016/s0165-0327(96)01427-9 · Cited by 259 · see citing works
Self-citationDifferential Response to Lithium and Carbamazepine in the Prophylaxis of Bipolar Disorder
Greil, W., Kleindienst Nikolaus, D.-S., Erazo Natalia, D.-P., & Muller-Oerlinghausen, B. (1998) · Journal of Clinical Psychopharmacology · doi:10.1097/00004714-199812000-00007 · Cited by 206 · see citing works
Self-citationEffect of Prophylactic Treatment on Suicide Risk in Patients with Major Affective Disorders
Thies-Flechtner, K., Müller-Oerlinghausen, B., Seibert, W., Walther, A., & Greil, W. (1996) · Pharmacopsychiatry · doi:10.1055/s-2007-979553 · Cited by 204 · see citing works
Self-citationParoxetine is better than placebo in relapse prevention and the prophylaxis of recurrent depression
Montgomery, S. A., & Dunbar, G. (1993) · International Clinical Psychopharmacology · doi:10.1097/00004850-199300830-00009 · Cited by 190 · see citing works
(1995) · PubMed · Cited by 174 · see citing works
Valproate in the Treatment of Bipolar Disorder
McElroy, S. L., Keck, P. E., Pope, H. G., & Hudson, J. I. (1992) · Journal of Clinical Psychopharmacology · doi:10.1097/00004714-199202001-00007 · Cited by 171 · see citing works
Anticonvulsants in affective disorders
Emrich, H. M., 大熊, 輝., & Müller, A. A. (1984) · Excerpta Medica eBooks · Cited by 165 · see citing works
Does Lithium Treatment Still Work?: Evidence of Stable Responses Over Three Decades
Baldessarini, R. J., & Tondo, L. (2000) · Archives of General Psychiatry · doi:10.1001/archpsyc.57.2.187 · Cited by 164 · see citing works
The place of anticonvulsant therapy in bipolar illness
Post, R. M., Ketter, T. A., Denicoff, K. D., Pazzaglia, P. J., Leverich, G. S., Marangell, L. B., Callahan, A. M., George, M. S., & Frye, M. A. (1996) · Psychopharmacology · doi:10.1007/s002130050117 · Cited by 155 · see citing works
Lithium Prophylaxis in Recurrent Affective Illness
Guscott, R. G., & Taylor, L. K. (1994) · The British Journal of Psychiatry · doi:10.1192/bjp.164.6.741 · Cited by 130 · see citing works
Is clozapine a mood stabilizer?
Zarate, C. A., Tohen, M. F., Banov, M. D., Weiss, M. K., & Cole, J. O. (1995) · PubMed · Cited by 130 · see citing works
Lamotrigine in Rapid-Cycling Bipolar Disorder
Fatemi, S. H., RAPPORT, D. J., Calabrese, J. R., & THURAS, P. D. (1997) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v58n1202 · Cited by 120 · see citing works
Advances in behavioral-cognitive therapy of social phobia.
Marks, I. M. (1995) · PubMed · Cited by 119 · see citing works
Gabapentin in the treatment of bipolar disorder
Schaffer, C. B., & Schaffer, L. C. (1997) · American Journal of Psychiatry · doi:10.1176/ajp.154.2.291 · Cited by 110 · see citing works
Antidepressant effects of lamotrigine in rapid cycling bipolar disorder
Calabrese, J. R., Fatemi, S. H., & Woyshville, M. J. (1996) · American Journal of Psychiatry · doi:10.1176/ajp.153.9.1236a · Cited by 110 · see citing works
Anticonvulsants and antipsychotics in the treatment of bipolar disorder.
Keck, P. E., McElroy, S. L., & Strakowski, S. M. (1998) · PubMed · Cited by 103 · see citing works
The Effect of Carbamazepine and Lithium on Remission from Affective Illness
Watkins, S. E., Callender, K., Thomas, D. R., Tidmarsh, S. F., & Shaw, D. (1987) · The British Journal of Psychiatry · doi:10.1192/bjp.150.2.180 · Cited by 100 · see citing works
Antipsychotic agents and bipolar disorder.
Tohen, M. F., & Zarate, C. A. (1998) · PubMed · Cited by 95 · see citing works
Predictors of Response to Mood Stabilizers
CALABRESE, J. R., FATEMI, S. H., KUJAWA, M., & WOYSHVILLE, M. J. (1996) · Journal of Clinical Psychopharmacology · doi:10.1097/00004714-199604001-00004 · Cited by 95 · see citing works
Adherence to Lithium Prophylaxis: I. Clinical Predictors and Patient's Reasons for Nonadherence
Maarbjerg, K., Aagaard, J., & Vestergaard, P. (1988) · Pharmacopsychiatry · doi:10.1055/s-2007-1014662 · Cited by 89 · see citing works
Comparison of Carbamazepine and Lithium in the Prophylaxis of Bipolar Disorders
Dardennes, R. M., EVEN, C., Bange, F., & Heim, A. (1995) · The British Journal of Psychiatry · doi:10.1192/bjp.166.3.378 · Cited by 89 · see citing works
Stoll, A. L., Tohen, M. F., Baldessarini, R. J., Goodwin, D. C., Stein, S., Katz, S. E., Geenens, D. L., Swinson, R. P., Goethe, J. W., & McGlashan, T. H. (1993) · American Journal of Psychiatry · doi:10.1176/ajp.150.11.1668 · Cited by 85 · see citing works
Greil, W., Ludwig‐Mayerhofer, W., Erazo, N., Engel, R. R., Czernik, A., Giedke, H., Müller-Oerlinghausen, B., Osterheider, M., Rudolf, G. A. E., Sauer, H., et al. (1996) · Journal of Affective Disorders · doi:10.1016/0165-0327(96)00070-5 · Cited by 81 · see citing works
Self-citationGreil, W., Ludwig‐Mayerhofer, W., Erazo, N., Engel, R. R., Czernik, A., Giedke, H., Müller-Oerlinghausen, B., Osterheider, M., Rudolf, G. A. E., Sauer, H., et al. (1997) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/bf02916252 · Cited by 78 · see citing works
Self-citationLong-term use of valproate in primary psychiatric disorders.
Hayes, S. G. (1989) · PubMed · Cited by 74 · see citing works
Current Therapeutic Profile of Lithium
Gershon, S. (1997) · Archives of General Psychiatry · doi:10.1001/archpsyc.1997.01830130020004 · Cited by 70 · see citing works
Greil, W., & Kleindienst, N. (1999) · International Clinical Psychopharmacology · doi:10.1097/00004850-199909000-00002 · Cited by 64 · see citing works
Self-citationRapid cycling bipolar disorder and its treatment with valproate.
Calabrese, J. R., RAPPORT, D. J., Kimmel, S. E., Reece, B., & Woyshville, M. J. (1993) · PubMed · Cited by 57 · see citing works
Understanding Manic-depressive Illness
Goodwin, F. K., & Ghaemi, S. N. (1998) · Archives of General Psychiatry · doi:10.1001/archpsyc.55.1.23 · Cited by 56 · see citing works
Has the Effectiveness of Lithium Changed? Impact of the Variety of Lithium's Effects
Grof, P. (1998) · Neuropsychopharmacology · doi:10.1016/s0893-133x(98)00023-2 · Cited by 48 · see citing works
Lithium response and the sequence of episode polarities: Preliminary report on a hamilton sample
Grof, E., Haag, M., Grof, P., & Haag, H. (1987) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/0278-5846(87)90060-1 · Cited by 46 · see citing works
Juckel, G., Hegerl, U., Mavrogiorgou, P., Gallinat, J., Mager, T., Tigges, P., Dresel, S. H. J., Schroter, A., Stotz, G., Meller, I., et al. (2000) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v61n0808 · Cited by 38 · see citing works
Self-citationIs Your ‘Double-Blind’ Design Truly Double-Blind?
Oxtoby, A., Jones, A., & Robinson, M. W. (1989) · The British Journal of Psychiatry · doi:10.1192/s0007125000018225 · Cited by 33 · see citing works
Predictors of Lithium Treatment Responsiveness in Bipolar Patients
Kusalic, M., & Engelsmann, F. F. (1998) · Neuropsychobiology · doi:10.1159/000026497 · Cited by 32 · see citing works
Greil, W., Ludwig‐Mayerhofer, W., Steller, B., Czernik, A., Giedke, H., Müller-Oerlinghausen, B., Osterheider, M., Rudolf, G. A. E., Sauer, H., Tegeler, J., et al. (1993) · Journal of Affective Disorders · doi:10.1016/0165-0327(93)90061-n · Cited by 32 · see citing works
Self-citationLithium Treatment in Aarhus. 2. Risk of Renal Failure and of Intoxication
Schou, M., Hansen, H. E., Thomsen, K., & Vestergaard, P. (1989) · Pharmacopsychiatry · doi:10.1055/s-2007-1014588 · Cited by 30 · see citing works
Has the Time Come to Abandon Prophylactic Lithium Treatment? A Review for Clinicians
Schou, M. (1998) · Pharmacopsychiatry · doi:10.1055/s-2007-979330 · Cited by 28 · see citing works
The prophylactic efficacy of lithium - transient or persistent?
Kleindienst, N., Greil, W., Rüger, B., & Möller, H. ‐. (1999) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s004060050079 · Cited by 25 · see citing works
Self-citationRe-evaluating carbamazepine prophylaxis in bipolar disorder
Post, R. M., Denicoff, K. D., Frye, M. A., & Leverich, G. S. (1997) · The British Journal of Psychiatry · doi:10.1192/s0007125000146525 · Cited by 23 · see citing works
Anticonvulsant drugs in bipolar disorder
Grunze, H., Schlösser, S., Amann, B. L., & Walden, J. (1999) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.1999.1.1/hgrunze · Cited by 17 · see citing works
Bipolar Disorders in DSM-IV: Impact of Inclusion of Rapid Cycling as a Course Modifier
Dünner, D. L. (1998) · Neuropsychopharmacology · doi:10.1016/s0893-133x(98)00024-4 · Cited by 17 · see citing works
Discrepancies in the Efficacy of Lithium
Grof, P., & Alda, M. (2000) · Archives of General Psychiatry · doi:10.1001/archpsyc.57.2.191 · Cited by 16 · see citing works
Differential Diagnosis of Bipolar Disorder
Dünner, D. L. (1992) · Journal of Clinical Psychopharmacology · doi:10.1097/00004714-199202001-00002 · Cited by 15 · see citing works
Response to Stabilising Lithium Therapy and Sequence of Affective Polarity
Haag, M., Heidorn, A., Haag, H. B., & Greil, W. (1986) · Pharmacopsychiatry · doi:10.1055/s-2007-1017233 · Cited by 14 · see citing works
Self-citationShifts in hospital diagnostic frequencies: bipolar disorder subtypes, 1981–1993
Zarate, C. A., Tohen, M. F., Baraibar, G., Zarate, S. B., & Baldessarini, R. J. (1997) · Journal of Affective Disorders · doi:10.1016/s0165-0327(96)01410-3 · Cited by 10 · see citing works
Hanuš, H., & Zapletálek, M. (1984) · PubMed · Cited by 10 · see citing works
[Calcium antagonists and lithium in preventive treatment of manic-depressive disorder].
Sarfati, Y., Spadone, C., Vanelle, J., & Lôo, H. (1996) · PubMed · Cited by 4 · see citing works
Flagged first, then by citations
1 of the 59 references couldn’t be matched to a known paper.
Research works printed but not linked: 5
- [20]20. Sarfati Y, Spadone C, Vanelle JM, Loo H: Inhibiteurs calciques et lithium dans le traite- ment prophylactique de la maladie maniaco- dépressive. Encéphale 1996;22:149-153.
- [24]24. Marcotte D, Gullick A: Use of topiramte, a new antiepileptic, as a mood stabilizer. J Affect Dis- ord 1998;50:245-251.
- [48]48. Kusalic M, Engelsmann F: Predictors of lithi- um treatment responsiveness in bipolar pa- tients. A two-year prospective study. Neuro- psychobiology 1998;37:146-149.
- [60]60. Swann AC, Bowden CL, Morris D, Calabrese JR, Petty F, Small J, Dilsaver SC, Davis JM: Depression during mania. Treatment response to lithium or divalproex. Arch Gen Psychiatry 1997;54:37-42.
- [63]63. Calabrese JR, Fatemi SH, Woyshville MJ: An- tidepressant effects of lamotrigine in rapid cy- cling bipolar disorder. Am J Psychiatry 1996; 153:1236.
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Sorted by citations
Yatham, L. N., Kennedy, S. H., Parikh, S. V., Schaffer, A., Bond, D. J., Frey, B. N., Sharma, V., Goldstein, B. I., Rej, S., Beaulieu, S., et al. (2018) · Bipolar Disorders · doi:10.1111/bdi.12609 · Cited by 1,852 · see citing works
Suicidal Behaviour in Bipolar Disorder
Tondo, L., Isacsson, G., & Baldessarini, R. J. (2003) · CNS Drugs · doi:10.2165/00023210-200317070-00003 · Cited by 399 · see citing works
Yatham, L. N., Kennedy, S. H., O'Donovan, C., Parikh, S., MacQueen, G., McIntyre, R., Sharma, V., Silverstone, P., Alda, M., Baruch, P., et al. (2005) · Bipolar Disorders · doi:10.1111/j.1399-5618.2005.00219.x · Cited by 388 · see citing works
Calabrese, J. R., Huffman, R., White, R. L., Edwards, S., Thompson, T. R., Ascher, J. A., Monaghan, E., & Leadbetter, R. A. (2008) · Bipolar Disorders · doi:10.1111/j.1399-5618.2007.00500.x · Cited by 243 · see citing works
Goodwin, F. K. (2003) · PubMed · Cited by 210 · see citing works
Clinical use of lithium salts: guide for users and prescribers
for the International Group for Studies of Lithium (IGSLi), Tondo, L., Alda, M., Bauer, M., Bergink, V., Grof, P., Hájek, T., Lewitzka, U., Licht, R. W., Manchia, M., et al. (2019) · International Journal of Bipolar Disorders · doi:10.1186/s40345-019-0151-2 · Cited by 205 · see citing works
Smith, L. A., Cornelius, V. R., Warnock, A., Bell, A. J., & Young, A. H. (2007) · Bipolar Disorders · doi:10.1111/j.1399-5618.2007.00490.x · Cited by 186 · see citing works
Schaffer, A., Isometsä, E. T., Tondo, L., Moreno, D. H., Sinyor, M., Kessing, L. V., Turecki, G., Weizman, A., Azorin, J.-M., Ha, K., et al. (2015) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867415594427 · Cited by 175 · see citing works
Mármol, F. (2008) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2008.08.012 · Cited by 174 · see citing works
Treatment of bipolar disorder: a systematic review of available data and clinical perspectives
Fountoulakis, K. Ν., & Vieta, E. (2008) · The International Journal of Neuropsychopharmacology · doi:10.1017/s1461145708009231 · Cited by 172 · see citing works
Kishi, T., Ikuta, T., Matsuda, Y., Sakuma, K., Okuya, M., Mishima, K., & Iwata, N. (2021) · Molecular Psychiatry · doi:10.1038/s41380-020-00946-6 · Cited by 169 · see citing works
Bipolar disorder and mechanisms of action of mood stabilizers
Rapoport, S. I., Basselin, M., Kim, H., & Rao, J. S. (2009) · Brain Research Reviews · doi:10.1016/j.brainresrev.2009.06.003 · Cited by 155 · see citing works
Efficacy of pharmacotherapy in bipolar disorder: a report by the WPA section on pharmacopsychiatry
Fountoulakis, K. Ν., Kasper, S. F., Andreassen, O. A., Blier, P., Okasha, A., Severus, E., Versiani, M., Tandon, R., Möller, H., & Vieta, E. (2012) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-012-0323-x · Cited by 130 · see citing works
Krüger, S., Alda, M., Young, L. T., Goldapple, K., Parikh, S., & Mayberg, H. S. (2006) · American Journal of Psychiatry · doi:10.1176/appi.ajp.163.2.257 · Cited by 126 · see citing works
Lithium and suicide prevention in mood disorders and in the general population: A systematic review
Del Matto, L., Muscas, M., Murru, A., Verdolini, N., Anmella, G., Fico, G., Corponi, F., Carvalho, A. F., Samalin, L., Carpiniello, B., et al. (2020) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2020.06.017 · Cited by 120 · see citing works
Fountoulakis, K. Ν., Yatham, L. N., Grunze, H., Vieta, E., Young, A. H., Blier, P., Kasper, S. F., & Moeller, H. J. (2016) · The International Journal of Neuropsychopharmacology · doi:10.1093/ijnp/pyw100 · Cited by 115 · see citing works
Polytherapy in Bipolar Disorder
Lin, D., Mok, H., & Yatham, L. N. (2006) · CNS Drugs · doi:10.2165/00023210-200620010-00003 · Cited by 91 · see citing works
The phenotypic spectra of bipolar disorder
Alda, M. (2004) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2004.03.006 · Cited by 92 · see citing works
Treatment of bipolar depression: An update
Fountoulakis, K. Ν., Grunze, H., Panagiotidis, P., & Kaprinis, G. (2007) · Journal of Affective Disorders · doi:10.1016/j.jad.2007.10.016 · Cited by 87 · see citing works
A review of the evidence for carbamazepine and oxcarbazepine in the treatment of bipolar disorder
Hirschfeld, R. M. A., & Kasper, S. F. (2004) · The International Journal of Neuropsychopharmacology · doi:10.1017/s1461145704004651 · Cited by 89 · see citing works
Response to Lithium in Bipolar Disorder: Clinical and Genetic Findings
RYBAKOWSKI, J. K. (2014) · ACS Chemical Neuroscience · doi:10.1021/cn5000277 · Cited by 88 · see citing works
Joshi, G., Wozniak, J. R., Mick, E. O., Doyle, R., Hammerness, P. G., Georgiopoulos, A. M., Kotarski, M., Aleardi, M., Williams, C., Walls, S., et al. (2010) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/cap.2008.0162 · Cited by 85 · see citing works
Shao, L., Sun, X., Xu, L., Young, L. T., & Wang, J. (2005) · Life Sciences · doi:10.1016/j.lfs.2005.07.007 · Cited by 85 · see citing works
Licht, R. W., Vestergaard, P., Kessing, L. V., Larsen, J. K., & Thomsen, P. H. (2003) · Acta Psychiatrica Scandinavica · doi:10.1034/j.1600-0447.108.s419.1.x · Cited by 80 · see citing works
Genetic Influences on Response to Mood Stabilizers in Bipolar Disorder
RYBAKOWSKI, J. K. (2013) · CNS Drugs · doi:10.1007/s40263-013-0040-7 · Cited by 79 · see citing works
Treatment of bipolar disorder: a complex treatment for a multi-faceted disorder
Fountoulakis, K. N., Vieta, E., Siamouli, M., Valenti, M., Magiria, S., Oral, T., Fresno, D., Giannakopoulos, P., & Kaprinis, G. S. (2007) · Annals of General Psychiatry · doi:10.1186/1744-859x-6-27 · Cited by 76 · see citing works
Maintenance Therapies in Bipolar Disorder: Focus on Randomized Controlled Trials
Muzina, D. J., & Calabrese, J. R. (2005) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/j.1440-1614.2005.01649.x · Cited by 74 · see citing works
Maintenance therapies in bipolar disorders
Gitlin, M. J., & Frye, M. A. (2012) · Bipolar Disorders · doi:10.1111/j.1399-5618.2012.00992.x · Cited by 72 · see citing works
An Update on Antiepileptic Drugs and Suicide: Are There Definitive Answers Yet?
Hesdorffer, D. C., Berg, A. T., & Kanner, A. M. (2010) · Epiliepsy currents/Epilepsy currents · doi:10.1111/j.1535-7511.2010.01382.x · Cited by 70 · see citing works
Safety and tolerability of emerging pharmacological treatments for bipolar disorder
Dünner, D. L. (2005) · Bipolar Disorders · doi:10.1111/j.1399-5618.2005.00235.x · Cited by 69 · see citing works
Pharmacotherapy of bipolar mixed states
Krüger, S., Young, L. T., & Bräunig, P. (2005) · Bipolar Disorders · doi:10.1111/j.1399-5618.2005.00197.x · Cited by 68 · see citing works
Guideline for treatment of bipolar disorder by the J apanese S ociety of M ood D isorders, 2012
Kanba, S., Kato, T., Terao, T., & Yamada, K. (2013) · Psychiatry and Clinical Neurosciences · doi:10.1111/pcn.12060 · Cited by 67 · see citing works
Treatment of Bipolar Disorder in a Lifetime Perspective: Is Lithium Still the Best Choice?
Sani, G., Perugi, G., & Tondo, L. (2017) · Clinical Drug Investigation · doi:10.1007/s40261-017-0531-2 · Cited by 68 · see citing works
Challenging the Negative Perception of Lithium and Optimizing Its Long-Term Administration
RYBAKOWSKI, J. K. (2018) · Frontiers in Molecular Neuroscience · doi:10.3389/fnmol.2018.00349 · Cited by 62 · see citing works
Beynon, S., Soares‐Weiser, K., Woolacott, N. F., Duffy, S., & Geddes, J. R. (2008) · Journal of Psychopharmacology · doi:10.1177/0269881108093885 · Cited by 60 · see citing works
Thirty Years of Clinical Experience with Carbamazepine in the Treatment of Bipolar Illness
Post, R. M., Ketter, T. A., Uhde, T. W., & Ballenger, J. C. (2007) · CNS Drugs · doi:10.2165/00023210-200721010-00005 · Cited by 59 · see citing works
Ceron‐Litvoc, D., Soares, B. G. D. O., Geddes, J. R., Litvoc, J., & de Lima, M. S. (2008) · Human Psychopharmacology Clinical and Experimental · doi:10.1002/hup.990 · Cited by 60 · see citing works
Lithium – a continuing story in the treatment of bipolar disorder
Carney, S. M., & Goodwin, G. M. (2005) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2005.00521.x · Cited by 57 · see citing works
Frangou, S., Raymont, V., & Bettany, D. (2002) · Bipolar Disorders · doi:10.1034/j.1399-5618.2002.01223.x · Cited by 56 · see citing works
The Management of Individuals with Bipolar Disorder
Malhi, G. S., Adams, D., Cahill, C. M., Dodd, S., & Berk, M. (2009) · Drugs · doi:10.2165/11318850-000000000-00000 · Cited by 52 · see citing works
The clinical management of bipolar disorder complexity using a stratified model
Malhi, G. S., Bargh, D. M., Cashman, E. L., Frye, M. A., & Gitlin, M. J. (2012) · Bipolar Disorders · doi:10.1111/j.1399-5618.2012.00993.x · Cited by 48 · see citing works
Baethge, C., Baldessarini, R. J., Mathiske-Schmidt, K., Hennen, J. A., Berghöfer, A., Müller-Oerlinghausen, B., Bschor, T., Adli, M., & Bauer, M. (2005) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v66n0204 · Cited by 46 · see citing works
Carbamazepine and valproate for the treatment of bipolar disorder: a review of the literature
Nasrallah, H. A., Ketter, T. A., & Kalali, A. H. (2006) · Journal of Affective Disorders · doi:10.1016/j.jad.2006.04.030 · Cited by 45 · see citing works
Chen, C., & Lin, S. (2012) · BMC Psychiatry · doi:10.1186/1471-244x-12-47 · Cited by 43 · see citing works
Pharmacotherapy of bipolar II disorder: a critical review of current evidence
Hadjipavlou, G. A., Mok, H., & Yatham, L. N. (2004) · Bipolar Disorders · doi:10.1046/j.1399-5618.2003.00086.x · Cited by 43 · see citing works
Pfennig, A., Schlattmann, P., Alda, M., Grof, P., Glenn, T., Müller-Oerlinghausen, B., Suwalska, A., RYBAKOWSKI, J. K., Willich, S. N., Bauer, M., et al. (2010) · Bipolar Disorders · doi:10.1111/j.1399-5618.2010.00826.x · Cited by 41 · see citing works
Smith, E. G., Søndergård, L., Lopez, A. G., Andersen, P. K., & Kessing, L. V. (2009) · Journal of Affective Disorders · doi:10.1016/j.jad.2009.01.013 · Cited by 41 · see citing works
Ferensztajn‐Rochowiak, E., Chłopocka-Woźniak, M., & RYBAKOWSKI, J. K. (2020) · Brazilian Journal of Psychiatry · doi:10.1590/1516-4446-2020-1111 · Cited by 39 · see citing works
Bipolar II Disorder: An Overview of Recent Developments
Hadjipavlou, G. A., Mok, H., & Yatham, L. N. (2004) · The Canadian Journal of Psychiatry · doi:10.1177/070674370404901203 · Cited by 37 · see citing works
Is Your Depressed Patient Bipolar?
Kaye, N. (2005) · The Journal of the American Board of Family Medicine · doi:10.3122/jabfm.18.4.271 · Cited by 33 · see citing works
The armamentarium of treatments for bipolar disorder: a review of the literature
Cousins, D. A., & Young, A. H. (2006) · The International Journal of Neuropsychopharmacology · doi:10.1017/s1461145706007413 · Cited by 34 · see citing works
Beyond evidence‐based treatment of bipolar disorder: Rational pragmatic approaches to management
Post, R. M., Yatham, L. N., Vieta, E., Berk, M., & Nierenberg, A. A. (2019) · Bipolar Disorders · doi:10.1111/bdi.12813 · Cited by 31 · see citing works
Exemplar scoring identifies genetically separable phenotypes of lithium responsive bipolar disorder
Nunes, A., Stone, W., Ardau, R., Berghöfer, A., Bocchetta, A., Chillotti, C., Deiana, V., Degenhardt, F., Forstner, A. J., Garnham, J. S., et al. (2021) · Translational Psychiatry · doi:10.1038/s41398-020-01148-y · Cited by 33 · see citing works
Atypical antipsychotics and suicide in mood and anxiety disorders
Sharma, V. (2003) · Bipolar Disorders · doi:10.1111/j.1399-2406.2003.00062.x · Cited by 32 · see citing works
Latest maintenance data on lithium in bipolar disorder
Goodwin, G. M., & Geddes, J. R. (2003) · European Neuropsychopharmacology · doi:10.1016/s0924-977x(03)00078-6 · Cited by 31 · see citing works
Preventing Suicidal Behaviour in a General Hospital Psychiatric Service: Priorities for Programming
Links, P. S., & Hoffman, B. F. (2005) · The Canadian Journal of Psychiatry · doi:10.1177/070674370505000809 · Cited by 29 · see citing works
Treatment of bipolar disorder: New perspectives
Alda, M., Hájek, T., Calkin, C. V., & O’Donovan, C. (2008) · Annals of Medicine · doi:10.1080/07853890802409489 · Cited by 29 · see citing works
Mood Stabilizers of First and Second Generation
RYBAKOWSKI, J. K. (2023) · Brain Sciences · doi:10.3390/brainsci13050741 · Cited by 29 · see citing works
Historical Review of Carbamazepine for the Treatment of Bipolar Disorder
Stoner, S. C., Nelson, L. A., Lea, J. W., Marken, P. A., Sommi, R. W., & Dahmen, M. M. (2006) · Pharmacotherapy The Journal of Human Pharmacology and Drug Therapy · doi:10.1592/phco.27.1.68 · Cited by 23 · see citing works
Re‐evaluation of randomized control trials of lithium monotherapy: a cohort effect
Deshauer, D., Fergusson, D. A., Duffy, A. C., Albuquerque, J., & Grof, P. (2005) · Bipolar Disorders · doi:10.1111/j.1399-5618.2005.00206.x · Cited by 21 · see citing works
Acute and prophylactic effects of anticonvulsants in bipolar depression
Post, R. M., Speer, A. M., Obrocea, G. V., & Leverich, G. S. (2002) · Clinical Neuroscience Research · doi:10.1016/s1566-2772(02)00047-6 · Cited by 20 · see citing works
Lithium treatment – the state of the art for 2020
RYBAKOWSKI, J. K. (2020) · Psychiatria Polska · doi:10.12740/pp/128340 · Cited by 20 · see citing works
Use of polypharmacy and self-reported mood in outpatients with bipolar disorder
Adli, M., Whybrow, P. C., Grof, P., Rasgon, N., Gyulai, L., Baethge, C., Glenn, T., & Bauer, M. (2005) · International Journal of Psychiatry in Clinical Practice · doi:10.1080/13651500510029200 · Cited by 19 · see citing works
Genetics of Lithium Response in Bipolar Disorder
Papiol, S., Schulze, T. G., & Alda, M. (2018) · Pharmacopsychiatry · doi:10.1055/a-0590-4992 · Cited by 18 · see citing works
Bipolar II Disorder: Current and Future Treatment Options
El‐Mallakh, R. S., Weisler, R. H., Townsend, M. H., & Ginsberg, L. D. (2006) · Annals of Clinical Psychiatry · doi:10.1080/10401230600948480 · Cited by 18 · see citing works
Alves, V. N., Rêgo, T. H. M., de Nadai, E. P., & Machado, Y. D. C. (2022) · Research Society and Development · doi:10.33448/rsd-v11i15.37054 · Cited by 17 · see citing works
Wang, J. X., Le, G. H., Wong, S., Teopiz, K. M., Kwan, A. T. H., Rosenblat, J. D., Rhee, T. G., Ho, R., Lo, H. K. Y., Goldberg, J. F., et al. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.119487 · Cited by 20 · see citing works
Pharmacotherapy of Suicidal Behavior in Bipolar Disorder
Oquendo, M. A., Chaudhury, S. R., & Mann, J. J. (2005) · Archives of Suicide Research · doi:10.1080/13811110590929424 · Cited by 16 · see citing works
The management of bipolar disorder in primary care: A review of existing and emerging therapies
BERK, M., Dodd, S., & Berk, L. (2005) · Psychiatry and Clinical Neurosciences · doi:10.1111/j.1440-1819.2005.01365.x · Cited by 17 · see citing works
Diagnosis and management of patients with bipolar disorder in primary care.
Berk, M., Dodd, S., Berk, L., & Opie, J. (2005) · Europe PMC (PubMed Central) · Cited by 12 · see citing works
History of Suicide Prevention with Lithium Treatment
Tondo, L., & Baldessarini, R. J. (2025) · Pharmaceuticals · doi:10.3390/ph18020258 · Cited by 11 · see citing works
Rapid cycling bipolar disease: New concepts and treatments
Dubovsky, S. L. (2001) · Current Psychiatry Reports · doi:10.1007/s11920-001-0038-6 · Cited by 11 · see citing works
Updated perspectives on how and when lithium should be used in the treatment of mood disorders
RYBAKOWSKI, J. K., & Ferensztajn‐Rochowiak, E. (2023) · Expert Review of Neurotherapeutics · doi:10.1080/14737175.2023.2181076 · Cited by 10 · see citing works
Effectiveness of ultra-long-term lithium treatment: relevant factors and case series
Ferensztajn‐Rochowiak, E., Lewitzka, U., Chłopocka-Woźniak, M., & RYBAKOWSKI, J. K. (2024) · International Journal of Bipolar Disorders · doi:10.1186/s40345-024-00328-9 · Cited by 9 · see citing works
Carbamazepine extended-release capsules in bipolar disorder
Weisler, R. H. (2006) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.a808 · Cited by 8 · see citing works
Rethinking the Treatment Paradigm for Bipolar Depression: The Importance of Long-Term Management
Baldassano, C. F., Ballas, C. A., & O’Reardon, J. P. (2004) · CNS Spectrums · doi:10.1017/s1092852900004351 · Cited by 8 · see citing works
Recurrence of Mania or Depression Among Adult Bipolar Patients Who Continued Using Lithium
Kishi, T., Sakuma, K., Okuya, M., Matsuda, Y., Esumi, S., Hashimoto, Y., Hatano, M., Miyake, N., Miura, I., Miyahara, K., et al. (2020) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0000000000001264 · Cited by 7 · see citing works
Pharmacological agents to reduce readmissions in bipolar disorder
Rogers, J. P., & Taylor, M. J. (2017) · Journal of Psychopharmacology · doi:10.1177/0269881116672099 · Cited by 6 · see citing works
Anticonvulsants in the treatment of mood disorders: assessing current and future roles
Gilmer, W. S. (2001) · Expert Opinion on Pharmacotherapy · doi:10.1517/14656566.2.10.1597 · Cited by 6 · see citing works
Carbamazepine in the treatment of bipolar disorder: a systematic review
Boaventura, V., Lyrio, R. R., Nardi, A. E., & Cheniaux, E. (2023) · Jornal Brasileiro de Psiquiatria · doi:10.1590/0047-2085000000434 · Cited by 5 · see citing works
Drug Class Review: Antiepileptic Drugs for Indications Other Than Epilepsy
McDonagh, M. S., Peterson, K., Lee, N., & Thakurta, S. (2008) · Cited by 5 · see citing works
Bipolar disorder: what effect does treatment adherence have on risk of suicidal behavior?
López‐Castromán, J., Baca‐García, E., & Oquendo, M. A. (2009) · Revista de Psiquiatría y Salud Mental (English Edition) · doi:10.1016/s2173-5050(09)70030-5 · Cited by 5 · see citing works
Trastorno bipolar: ¿qué efecto tiene el cumplimiento terapéutico en el riesgo de conductas suicidas?
López‐Castromán, J., Baca‐García, E., & Oquendo, M. A. (2009) · Revista de Psiquiatría y Salud Mental · doi:10.1016/s1888-9891(09)70713-x · Cited by 4 · see citing works
Mood stabilisers in the treatment of Bipolar II Disorder
Hadjipavlou, G. A., & Yatham, L. N. (2008) · Cambridge University Press eBooks · doi:10.1017/cbo9780511544187.011 · Cited by 4 · see citing works
Fountoulakis, K. N. (2014) · Springer eBooks · doi:10.1007/978-3-642-37216-2_16 · Cited by 3 · see citing works
Lithium heute — ein Update seiner Wirksamkeit und Risiken
Müller-Oerlinghausen, B. (2019) · NeuroTransmitter · doi:10.1007/s15016-019-6601-3 · Cited by 3 · see citing works
Makara‐Studzińska, M., Morylowska-Topolska, J., Koślak, A., & Urbańska, A. (2012) · Journal of Elementology · doi:10.5601/jelem.2010.15.2.393-403 · Cited by 3 · see citing works
Fornaro, M., Lorenzo, C. D., Daray, F. M., & Kishi, T. (2026) · Journal of Affective Disorders · doi:10.1016/j.jad.2026.121798 · Cited by 2 · see citing works
Licht, R. W. (2015) · Elsevier eBooks · doi:10.1016/b978-0-12-405170-6.00010-5 · Cited by 2 · see citing works
RYBAKOWSKI, J. K. (2020) · Springer eBooks · doi:10.1007/978-3-319-56015-1_45-1 · Cited by 2 · see citing works
How to treat bipolar II depression and bipolar II mixed depression? – A reply to Benazzi
Calabrese, J. R. (2004) · The International Journal of Neuropsychopharmacology · doi:10.1017/s1461145703003961 · Cited by 2 · see citing works
Bipolar Spectrum Disorder: Origins and State of the Art
Tamayo, J. M., Cossio-Uribe, C. C., Florez, M. C., Tamayo-Calle, J., Marulanda, D., Mejia, C., Gómez, N. P., Gomez, A., Duque-Ochoa, S., Alvarez-Arboleda, L. M., et al. (2013) · Current Psychiatry Reviews · doi:10.2174/157340013805289653 · Cited by 2 · see citing works
Litio en Psiquiatría. / Lithium in Psychiatry.
Baldessarini, R. J., & Tondo, L. (2014) · Revista de Neuro-Psiquiatría · doi:10.20453/rnp.v76i4.1167 · Cited by 2 · see citing works
Relapse Prevention and Bipolar Disorder: A Focus on Bipolar Depression
Rapaport, M. H., & Hales, D. J. (2003) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/foc.1.1.15 · Cited by 2 · see citing works
Genetic studies of bipolar disorder in patients selected by their treatment response
Ortiz‐Domínguez, A., & Alda, M. (2008) · Redalyc (Universidad Autónoma del Estado de México) · Cited by 1 · see citing works
Current status of mood stabilisers in the management of Bipolar II disorder
Hadjipavlou, G. A., Bond, D. J., & Yatham, L. N. (2012) · Cambridge University Press eBooks · doi:10.1017/cbo9781139003315.012 · Cited by 1 · see citing works
Gli stabilizzatori dell’umore nel trattamento degli stati misti del disturbo bipolare
Rosso, G., Bertetto, N., Coppola, I., & Maina, G. (2012) · Rivista di psichiatria · doi:10.1708/1139.12555 · Cited by 1 · see citing works
RYBAKOWSKI, J. K. (2022) · Springer eBooks · doi:10.1007/978-3-030-62059-2_45 · Cited by 1 · see citing works
Sixty years of recurrence prevention in mood disorders
RYBAKOWSKI, J. K. (2024) · Psychiatria Polska · doi:10.12740/pp/169407 · Cited by 1 · see citing works
Psicofarmacología del suicidio: un análisis crítico
Martínez-Aguayo, J. C., Marcelo Arancibia, M., & Hernán Silva, I. (2015) · Revista chilena de neuro-psiquiatría · doi:10.4067/s0717-92272015000200008 · Cited by 1 · see citing works
- Authors
- Kleindienst, N., & Greil, W.
- Affiliations
- Ludwig-Maximilians-Universität München (DE)
- Sanatorium Kilchberg (CH)
- Venue
- Neuropsychobiology
- Publisher
- S. Karger AG
- Published
- 2000
- Volume
- 42
- Issue
- Suppl. 1
- Pages
- 2-10
- ISSN
- 0302-282X (ISSN-L)
- 1423-0224
- OpenAlex
- W2123443459
- Cited by
- 123
- References
- 59
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 2 · 2023: 4 · 2022: 3 · 2021: 2 · 2020: 11 · 2019: 3 · 2018: 3 · 2017: 2 · 2016: 1 · 2015: 4 · 2014: 3 · 2013: 4 · 2012: 9
- FWCI
- 2.57
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Neuropsychobiology (publishedVersion)
- PubMed (publishedVersion)
- Open access LMU (Ludwid Maxmilian's Universitat Munchen) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Keywords
- lithium, carbamazepine, bipolar disorder, prophylaxis, bipolar I disorder, bipolar II disorder, hospitalization rates, suicidal behavior, treatment satisfaction, comorbidities
- MeSH terms
- Adult, Bipolar Disorder, Carbamazepine, Female, Humans, Lithium, Male, Middle Aged, Patient Compliance, Patient Dropouts, Psychiatric Status Rating Scales, Suicide, Treatment Failure, Antimanic Agents
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