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Q Is divalproex more cost effective than lithium for adults with bipolar disorder?
METHODS
Design:
Randomised controlled trial.
Allocation:
Not clear.
Blinding:
Unblinded.
Follow up period:
Twelve months.
Setting:
Thirty three university and community based psychiatric practices, USA; 1995–97.
Patients:
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.
Intervention:
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.
Outcomes:
Quality of life (QOL; …
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