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Lithium is widely prescribed, but the timing of key effects remains uncertain. The timing of onset of its relapse prevention effects is clarified by placebo-controlled randomised trials (3 studies, n = 1120). Lithium reduced relapse into any mood episode over the first 2 weeks of treatment (hazard ratio 0.40, 95% CI 0.16-0.97). Fewer manic relapses were evident within the first 4 weeks, however, early effects on depressive relapse were not demonstrated. There is an early onset of lithium relapse prevention effects in bipolar disorder, particularly against manic relapse. Full effects against depressive relapse may develop over a longer period.Declaration of interestM.J.T. reports personal fees from Sunovion, Otsuka, Lundbeck, outside the submitted work.

Original publication

DOI

10.1192/bjp.2018.177

Type

Journal article

Journal

Br J Psychiatry

Publication Date

11/2018

Volume

213

Pages

664 - 666

Keywords

Bipolar affective disorders, mood stabilisers, randomized controlled trial, Bipolar Disorder, Drug Administration Schedule, Humans, Lithium, Randomized Controlled Trials as Topic, Secondary Prevention