The comparative prophylactic efficacy of lithium and carbamazepine in patients with bipolar I disorder

In a randomized prospective clinical trial with an observation period of 2.5 years, a subgroup analysis was tarried out for the 114 patients with bipolar I disorder (DSM-IV) regarding the prophylactic efficacy of lithium and carbamazepine. Treatment outcome was evaluated taking rehospitalization, recurrence, subclinical recurrence, concomitant medication and severe adverse effects into consideration. Special interest was paid to the enzyme-inducing properties of carbamazepine, which might lessen the efficacy of psychotropic comedication. Lithium was superior to carbamazepine in bipolar I patients for various outcome criteria. Analyses in patients without psychotropic comedication indicate that the superiority of lithium is not the result of carbamazepine reducing plasma levels of concomitant drugs. Int Clin Psychopharmacol 14:277-281 (C) 1999 Lippincott Williams & Wilkins.