© 2002 Evidence-Based Mental Health
Therapeutics
Lithium is more effective than placebo for preventing all relapses in patients with bipolar but not unipolar disorder
Burgess S, Geddes J, Hawton K, et al. Lithium for maintenance treatment of mood disorders. Cochrane Database Syst Rev 2001;(2):CD003013 (latest version Sep 27 2000).
QUESTION: In patients with recurrent mood disorder, is lithium more effective than placebo for preventing relapse?
Published and unpublished randomised controlled trials were identified by searching the Cochrane Controlled Clinical Trials Registers; by reviewing the reference lists of all identified trials, other relevant papers, and major textbooks on mood disorder; by handsearching the journals Lithium (1990–4) and Lithium Therapy Monographs (1987–91); and through personal contact with authors of trials included in the review, with other recognised experts, and with pharmaceutical companies.
Studies were selected if patients were diagnosed with mood disorder (primarily bipolar disorder and recurrent unipolar disorder), lithium was compared with placebo as maintenance treatment, and follow up was 
3 months. Trials that had lithium combined with another treatment, had unsound diagnoses, were categorised as awaiting assessment, or were discontinuation studies were excluded.
2 reviewers independently extracted data on patient characteristics, intervention details, and outcome measures. 2 different reviewers independently assessed study quality using the Cochrane Criteria for quality assessment and the Jadad scale. Main
Cambridge University Cambridge, UK
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