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Divalproex and lithium are similarly cost effective for adults with bipolar disorder

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Q Is divalproex more cost effective than lithium for adults with bipolar disorder?


Embedded ImageDesign:

Randomised controlled trial.

Embedded ImageAllocation:

Not clear.

Embedded ImageBlinding:


Embedded ImageFollow up period:

Twelve months.

Embedded ImageSetting:

Thirty three university and community based psychiatric practices, USA; 1995–97.

Embedded ImagePatients:

221 people 18 years or over with bipolar disorder (DSM-IV) hospitalised for an acute manic or mixed episode. Exclusions: serious neurological abnormalities; seizure disorders; drug or AIDS induced mania; uncontrolled medical comorbidity; taking anticoagulants; breastfeeding or likely to become pregnant.

Embedded ImageIntervention:

Divalproex sodium (15–20 mg/kg/day) or lithium (up to 1800 mg/day in the acute treatment phase; 900–1200 mg/day in the maintenance phase). All participants also received usual psychiatric care.

Embedded ImageOutcomes:

Quality of life (QOL; …

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  • For correspondence: D A Revicki, Center for Health Outcomes Research, MEDTAP International, 7101 Wisconsin Avenue, Suite 600, Bethesda, MD 20814, USA; revicki{at}

  • Sources of funding: Abbott Laboratories, Abbott Park, Illinois, USA