By Dennis Thompson
THURSDAY, Might 12, 2016 (HealthDay Information) — Lithium outperforms newer temper stabilizers within the remedy of bipolar dysfunction, a brand new research has discovered.
Sufferers taking lithium had decrease charges of self-harm and unintentional damage in comparison with these taking different bipolar medication, reminiscent of valproate (Depacon, Depakote), olanzapine (Zyprexa) or quetiapine (Seroquel), mentioned lead researcher Joseph Hayes. He’s a fellow of psychiatry at College Faculty London.
“That is vital as a result of individuals with bipolar dysfunction are 15 instances extra more likely to die by suicide and 6 instances extra more likely to die by unintentional damage than the overall inhabitants,” Hayes defined.
Folks taking one of many various temper stabilizers had been 40 % extra more likely to hurt themselves in comparison with sufferers on lithium, Hayes and his colleagues discovered.
And folks on valproate or quetiapine had been 32 % to 34 % extra more likely to fall sufferer to unintentional damage, most probably whereas experiencing a manic episode, the researchers mentioned.
“Lithium nonetheless is the gold normal for the remedy of bipolar. We actually have not had a drugs that surpasses lithium, so far as we all know,” mentioned Dr. Raphael Braga. He’s physician-in-charge of the Heart for Remedy and Analysis of Bipolar Dysfunction at Zucker Hillside Hospital in Glen Oaks, N.Y., and was not concerned with the research.
Hayes famous that lithium has been used for greater than half a century to deal with bipolar dysfunction, nevertheless it’s nonetheless not clear how the drug stabilizes an individual’s temper.
Bipolar dysfunction, which was once referred to as manic melancholy, is characterised by excessive temper swings starting from emotional highs to depressive lows.
The researchers undertook their research following proof evaluations and research that instructed lithium may be higher than newer drugs at stopping suicide and self-harm.
These research have contended that lithium achieves these outcomes by decreasing signs reminiscent of melancholy, aggression, risk-taking and impulsive conduct, in keeping with background notes within the research.
Lithium will be laborious on the physique, the research authors mentioned, rising an individual’s danger of kidney and thyroid illness, however even that will have a optimistic aspect in bipolar sufferers. As a result of sufferers have to be carefully monitored for unwanted side effects, they’re in additional frequent contact with medical doctors who can decide up on emotional issues that result in suicide, the researchers contend.
To match lithium towards newer drugs, Hayes and his colleagues collected medical knowledge on almost 6,700 individuals identified as bipolar and prescribed solely one of many medication — lithium, valproate, olanzapine or quetiapine.
The investigators discovered that individuals on lithium had been much less more likely to hurt themselves, both deliberately or by chance.
The suicide price was decrease within the lithium group, however too few suicides occurred to permit correct danger estimates, the research authors mentioned.
The findings had been revealed on-line Might 11 within the journal JAMA Psychiatry.
Lithium could cause kidney illness and hypothyroidism (underactive thyroid gland), Braga and Hayes mentioned.
Docs must fastidiously weigh advantages versus hurt when prescribing lithium to individuals with kidney or thyroid issues, and “if these are extreme, it needs to be averted,” Hayes mentioned. “Lithium [also] must be reviewed on a person affected person foundation earlier than being pregnant.”
Braga mentioned psychiatrists typically require sufferers taking lithium to endure lab assessments each three to 6 months, to verify their kidney operate hasn’t been compromised.
Even with this, lithium is less expensive than the opposite drugs within the research, Braga mentioned. Hayes famous a 2008 research that discovered lithium was almost $500 cheaper per thirty days in contrast with olanzapine.
“Lithium is a good drug,” Braga mentioned. “It is positively a drug each clinician ought to take into consideration when prescribing for bipolar dysfunction.”
For extra on lithium, go to the Nationwide Alliance on Psychological Sickness.