Comparing Lithium With Valproate for Clinical and Social Status of Bipolar Disorder Patients in Inter-Episode Interval: A Retrospective Comparative Study

Arash Mowla, Sanaz Boostani, Zahra Ehsaei


Background: Our aim was to compare the efficacy of Na valproate with lithium in prolonging the time to mood episode recurrence in patients suffering from bipolar disorder (BD) type 1. Patients’ social and occupational functioning in the inter-episode interval was also compared.

Methods: A total of 324 patients that were admitted in our psychiatry ward with diagnosis of BD, manic phase, were surveyed for their past psychiatry history. The patients entered the study if they had adhered to their mood stabilizing medications from their past mood episode till this current mood episode. A total of 169 patients were on lithium (mean dose: 785.7 mg) and 155 patients were on Na valproate (mean dose: 734.3 mg) while admitted. The time period the patients were in the inter-episode interval was compared between the two groups. The patients’ occupational and social functioning in the inter-episode interval was also compared.

Results: The inter-episode interval was 28.7 months in the patients taking lithium and 29.4 months in the patients on Na valproate. There was no significant difference in this regard between the two groups (P = 0.564). Furthermore, rates of substance abuse (0.561), divorce (0.543), suicidal attempt (0.693) and unemployment (P = 0.453) in the inter-episode interval did not differ significantly between the lithium and valproate groups.

Conclusions: Na valproate was demonstrated to be as effective as lithium in preventing mood episode recurrence in bipolar patients. Our patients also demonstrated comparable occupational and social status in the inter-episode interval.

J Neurol Res. 2020;10(6):226-230


Valproate; Lithium; Bipolar disorder

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