Lithium Bests Newer Drugs for Bipolar Disorder

Woman with depression sitting in the corner of the room

While it has been around for decades to treat bipolar disorder, the drug lithium works better than newer -– and more expensive –- mood stabilizers in terms of lower rates of self-harm and unintended injury.

Researchers led by Joseph F. Hayes, MSc, MB, ChB, of University College London, looked at rates of self-harm, unintentional injury and suicide deaths in patients prescribed lithium, Depakote (valproate), Zyprexa (olanzapine) or Seroquel (quetiapine). They examined electronic health records of more than 6,671 individuals diagnosed with bipolar disorder and given one of the drugs.

Overall, people who were not taking lithium and were on one of the other mood stabilizers were 40% more likely have harmed themselves in comparison to those on lithium, according to results published in JAMA Psychiatry. Also, those on Depakote were 32% to 34% more likely to sustain an unintended injury.

The finding “supports the hypothesis that lithium use reduces impulsive aggression in addition to stabilizing mood,” the study authors conclude, reinforcing lithium as the “gold standard” in the treatment of bipolar disorder.

However, lithium itself is not without side effects. These include a risk of kidney disease and hypothyroidism, or an underactive thyroid gland. As a result, people on lithium are often required to undergo lab tests every 3 to 6 months to make sure their kidneys are functioning correctly.

Lithium is also far cheaper than the other drugs examined in the study. For example, a 2008 studyfound that Zyprexa is $500 more expensive per month than lithium.

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