Double-blind 18-month trial of lithium versus divalproex maintenance treatment in pediatric bipolar disorder

Robert L Findling, Nora K. McNamara, Eric A. Youngstrom, Robert Stansbrey, Barbara L. Gracious, Michael D. Reed, Joseph R. Calabrese

Research output: Contribution to journalArticle

Abstract

Objective: To determine whether divalproex sodium (DVPX) was superior to lithium carbonate (Li+) in the maintenance monotherapy treatment of youths diagnosed with bipolar disorder who had been previously stabilized on combination Li+ and DVPX (Li+/DVPX) pharmacotherapy. Method: Youths ages 5-17 years with bipolar I or II disorder were initially treated with Li+ /DVPX. Patients meeting remission criteria for four consecutive weeks were then randomized in a double-blind fashion to treatment with either Li+ or DVPX for up to 76 weeks. Study participation ended if the subject required additional clinical intervention or if the subject did not adhere to study procedures. Results: Patients were recruited between July 1998 and May 2002. One hundred thirty-nine youths with a mean (SD) age of 10.8 (3.5) years were initially treated with Li+/DVPX for a mean (SD) duration of 10.7 (5.4) weeks. Sixty youths were then randomized to receive monotherapy with Li+ (n = 30) or DVPX (n = 30). The Li+ and DVPX treatment groups did not differ in survival time until emerging symptoms of relapse (p = .55) or survival time until discontinuation for any reason (p = .72). Conclusions: DVPX was not found to be superior to Li + as maintenance treatment in youths who stabilized on combination Li+ /DVPX pharmacotherapy.

Original languageEnglish (US)
Pages (from-to)409-417
Number of pages9
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Volume44
Issue number5
DOIs
StatePublished - May 2005
Externally publishedYes

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Valproic Acid
Bipolar Disorder
Lithium
Pediatrics
Therapeutics
Lithium Carbonate
Drug Therapy
Survival
Maintenance
Recurrence

Keywords

  • Bipolar disorder
  • Divalproex sodium
  • Lithium

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Developmental and Educational Psychology

Cite this

Double-blind 18-month trial of lithium versus divalproex maintenance treatment in pediatric bipolar disorder. / Findling, Robert L; McNamara, Nora K.; Youngstrom, Eric A.; Stansbrey, Robert; Gracious, Barbara L.; Reed, Michael D.; Calabrese, Joseph R.

In: Journal of the American Academy of Child and Adolescent Psychiatry, Vol. 44, No. 5, 05.2005, p. 409-417.

Research output: Contribution to journalArticle

Findling, Robert L ; McNamara, Nora K. ; Youngstrom, Eric A. ; Stansbrey, Robert ; Gracious, Barbara L. ; Reed, Michael D. ; Calabrese, Joseph R. / Double-blind 18-month trial of lithium versus divalproex maintenance treatment in pediatric bipolar disorder. In: Journal of the American Academy of Child and Adolescent Psychiatry. 2005 ; Vol. 44, No. 5. pp. 409-417.
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