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Bipolar disorder in young people: divalproex sodium no more effective than lithium for maintenance

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Q Is divalproex more effective than lithium as a monotherapy for young people with bipolar disorder who are stabilised on lithium plus divalproex?

METHODS

Embedded ImageDesign:

Randomised controlled trial.

Embedded ImageAllocation:

Unclear.

Embedded ImageBlinding:

Double blind.

Embedded ImageFollow up period:

76 weeks.

Embedded ImageSetting:

Single site outpatient setting, USA; recruitment between July 1998 and May 2002.

Embedded ImagePatients:

139 young people aged 5–17 years with bipolar I or bipolar II disorder (DSM-IV diagnosis) and who had at least one manic or hypomanic episode in the previous three months. Main exclusion criteria: history of manic episodes with either lithium serum concentration ⩾1.0 mmol/l or divalproex sodium (DVP) concentration ⩾80 μg/ml; pregnancy; recent substance misuse disorder; pervasive developmental disorder or mental retardation; or significant medical comorbidity.

Embedded ImageIntervention:

All participants received lithium plus divalproex sodium for up to 20 weeks …

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