%0 Journal Article
%T Clinical course and need for hospital admission after lithium discontinuation in patients with bipolar disorder type i or II: Mirror-image study based on the LiSIE retrospective cohort
%J BJPsych open
%D 2019
%A Öhlund, L.
%A Ott, M.
%A Bergqvist, M.
%A Oja, S.
%A Lundqvist, R.
%A Sandlund, M.
%A Renberg, E.S.
%A Werneke, U.
%V 5
%N 6
%P -
%X Background Currently, the evidence for lithium as a maintenance treatment for bipolar disorder type II (BD-II) remains limited. Guidelines commonly extrapolate recommendations for BD-II from available evidence for bipolar disorder type I (BD-I). Comparing the impact of lithium discontinuation is one way of assessing effectiveness in both groups. AimsTo compare the impact of lithium discontinuation on hospital admissions and self-harm in patients with BD-I or schizoaffective disorder (SZD) and patients with BD-II or other bipolar disorder. <br><br>METHOD Mirror-image study, examining hospital admissions within 2 years before and after lithium discontinuation in both patient groups. This study was part of a retrospective cohort study (LiSIE) into effects and side-effects of lithium for maintenance treatment of bipolar disorder as compared with other mood stabilisers. <br><br>RESULTS For the whole sample, the mean number of admissions/patient/review period doubled from 0.44 to 0.95 (P<0.001) after lithium discontinuation. The mean number of bed days/patient/review period doubled from 11 to 22 (P = 0.025). This increase in admissions and bed days was exclusively attributable to patients with BD-I/SZD. Not having consulted with a doctor prior to lithium discontinuation or no treatment with an alternative mood stabiliser at the time of lithium discontinuation led to more admissions. <br><br>CONCLUSIONS The higher relapse risk in patients with BD-I/SZD suggests a higher threshold for discontinuing lithium than for patients with BD-II/other bipolar disorder. In patients with BD-II/other bipolar disorder, however, judged on the impact of discontinuation alone, lithium did not appear to prevent more severe depressive episodes requiring hospital admission. Copyright © The Author(s) 2019.<p /><p>Language: en</p>
%G en
%I Royal College of Psychiatrists
%@ 2056-4724
%U http://dx.doi.org/10.1192/bjo.2019.83