Featured Research

from universities, journals, and other organizations

Combination therapy better than leading drug for bipolar disorder, study suggests

Date:
January 5, 2010
Source:
University of Oxford
Summary:
People with bipolar disorder are less likely to suffer a relapse if they are taking both lithium and sodium valproate rather than the drug valproate alone, a new study has shown.

People with bipolar disorder are less likely to suffer a relapse if they are taking both lithium and sodium valproate rather than the drug valproate alone, an Oxford University study has shown.

Sodium valproate (available as Depakote) has been increasingly prescribed over lithium (Priadel) as a long-term therapy for bipolar disorder, particularly in North America. But the findings of the randomised trial, published in the medical journal The Lancet, suggest that those who have been prescribed valproate would fare better if lithium was added to their therapy, or if they changed to lithium alone.

'Our study indicates that a combination therapy of lithium plus valproate may be preferable for people with bipolar disorder over valproate alone, as there were significantly fewer relapses among those on both drugs over the two year period of the trial,' says Professor John Geddes of the Department of Psychiatry at the University of Oxford, who led the research.

About 1 in 100 people are diagnosed as having bipolar disorder (also known as manic depression), a mood disorder characterised by swings in a person's mood, including depression and mania. During a severe depressive episode, people may have feelings of hopelessness and despair, and have difficulty in carrying on with daily activities and work. In the manic phase, people may be overactive, lose judgement, become sexually uninhibited, and have grandiose ideas or delusions.

For many years, the standard therapy was lithium carbonate, a mood-stabilising drug. However, the dose must be carefully managed so anyone taking lithium must have regular blood tests, and it can cause adverse side-effects that some patients can't tolerate.

As a result anticonvulsant and antipsychotic drugs have been proposed as alternatives -- most of these are drugs already used for epilepsy, schizophrenia or depression, rather than new treatments for bipolar disorder itself. Sodium valproate is an effective anticonvulsant agent, and it has been increasingly prescribed for bipolar disorder since the 1990s. There are also non-drug, psychological or 'talking' treatments that have been shown to have some benefit in bipolar disorder.

The Oxford team investigated whether a combination therapy including both lithium and valproate would be better than either drug alone in preventing relapse in bipolar disorder.

330 people with bipolar disorder and aged over 16 were randomised to receive valproate, lithium, or both in combination, with 110 people in each group. The trial was carried out at 41 standard clinical centres in the UK, USA, Italy and France, so that the results would be as clinically relevant as possible. The trial team recorded any relapses among the participants that required new treatment or admission to hospital over a two-year period.

Relapses occurred in 76 people on valproate therapy (69% of the 110 people in this treatment group), 65 people on lithium (59%), and 59 people on the combination therapy (54%).

The results showed that the combination of lithium plus valproate is more likely to prevent relapse than valproate alone. Lithium by itself is also slightly more effective than valproate. The study also suggests that the combination therapy may be better than lithium alone, but the differences are not statistically significant.

'Lots of people are prescribed valproate for a manic episode,' says Professor Geddes. 'Once the acute episode has settled, their doctor might then consider whether valproate might be considered long-term. Actually, our work shows that a better outcome would be more likely if lithium is added in. And if a monotherapy is to be used, lithium is better than valproate at preventing relapses.'

He adds: 'Even with the combination therapy, most people needed additional treatment within the two years of the trial. It's clear that there is room for great improvements in therapies for bipolar disorder. In particular, we would like to know why lithium -- the simple light metal element -- is superior to other drugs we've tried. We need to reinvigorate research to understand exactly what lithium does in the body and come up with new medicines that are as effective, but that are safer and easier to take.'

The research was funded by the Stanley Medical Research Institute and Sanofi-Aventis.


Story Source:

The above story is based on materials provided by University of Oxford. Note: Materials may be edited for content and length.


Cite This Page:

University of Oxford. "Combination therapy better than leading drug for bipolar disorder, study suggests." ScienceDaily. ScienceDaily, 5 January 2010. <www.sciencedaily.com/releases/2009/12/091231165336.htm>.
University of Oxford. (2010, January 5). Combination therapy better than leading drug for bipolar disorder, study suggests. ScienceDaily. Retrieved July 31, 2014 from www.sciencedaily.com/releases/2009/12/091231165336.htm
University of Oxford. "Combination therapy better than leading drug for bipolar disorder, study suggests." ScienceDaily. www.sciencedaily.com/releases/2009/12/091231165336.htm (accessed July 31, 2014).

Share This




More Mind & Brain News

Thursday, July 31, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Dieting At A Young Age Might Lead To Harmful Health Habits

Dieting At A Young Age Might Lead To Harmful Health Habits

Newsy (July 30, 2014) Researchers say women who diet at a young age are at greater risk of developing harmful health habits, including eating disorders and alcohol abuse. Video provided by Newsy
Powered by NewsLook.com
It's Not Just Facebook: OKCupid Experiments With Users Too

It's Not Just Facebook: OKCupid Experiments With Users Too

Newsy (July 29, 2014) If you've been looking for love online, there's a chance somebody has been looking at how you're looking. Video provided by Newsy
Powered by NewsLook.com
How Your Face Can Leave A Good Or Bad First Impression

How Your Face Can Leave A Good Or Bad First Impression

Newsy (July 29, 2014) Researchers have found certain facial features can make us seem more attractive or trustworthy. Video provided by Newsy
Powered by NewsLook.com
Losing Sleep Leaves You Vulnerable To 'False Memories'

Losing Sleep Leaves You Vulnerable To 'False Memories'

Newsy (July 27, 2014) A new study shows sleep deprivation can make it harder for people to remember specific details of an event. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

    Environment News

    Technology News



      Save/Print:
      Share:

      Free Subscriptions


      Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

      Get Social & Mobile


      Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

      Have Feedback?


      Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
      Mobile: iPhone Android Web
      Follow: Facebook Twitter Google+
      Subscribe: RSS Feeds Email Newsletters
      Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins