Original scientific paper

LONG TERM USE OF LITHIUM AND FACTORS ASSOCIATED WITH TREATMENT RESPONSE AMONG PATIENTS WITH BIPOLAR DISORDER

Gan Wei Shan ; Faculty of Pharmacy, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
Mohd Makmor-Bakry ; Faculty of Pharmacy, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
Marhanis Salihah Omar ; Faculty of Pharmacy, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia

Abstract

Background: Lithium has been the gold standard in treating bipolar disorder. In recent years, the use of lithium seems to be
diminished although it is well tolerated among the bipolar disorder patients.
Subjects and methods: This study aimed to evaluate the efficacy and tolerability of lithium as well as to determine factors
associated with lithium response among patient with bipolar disorder. A retrospective study was done in a tertiary care hospital in
Malaysia which included 47 bipolar disorder patients that were prescribed with lithium maintenance therapy in the time frame of
January 2009 until December 2013.
Results: Of all the baseline characteristics tested, only psychotic feature differentiated lithium monotherapy group and
combination therapy group significantly (χ2=4.732, p=0.03). When compared to period before lithium maintenance, all outcome
measures (i.e. annual relapse rate, proportion time spent ill and duration of mood episode) showed significant improvement after
lithium maintenance in both treatment groups. Lithium discontinuation only occurred in five cases of adverse effects. Predominant
depressive mood episode before lithium maintenance (OR=0.159, p=0.033) and first euthymic interval after lithium maintenance
(OR=1.109, p=0.047) significantly predicted lithium response.
Discussion: Lithium significantly reduced the frequency and time spent in relapse in patients with bipolar disorder. Predominant
depressive mood polarity before lithium maintenance and longer first euthymic interval after lithium maintenance had been identified
to predict lithium response significantly.

Keywords

lithium; bipolar disorder; response; relapse rate; predominant depressive mood episode

Hrčak ID:

175261

URI

https://hrcak.srce.hr/175261

Publication date:

7.6.2016.

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