AN OPEN COMPARATIVE AND RANDOMIZED STUDY ON VALPROATE’S EFFECT IN THE LONG-TERM TREATMENT OF BIPOLAR DISORDERS VERSUS LITHIUM CARBONATE AND CARBAMAZEPINE

  • Fatime Elezi Neuroscience Department, Psychiatric Service, Emergency Ward, University Hospital Center “Mother Teresa”, Tirana, Albania
  • Sonila Tomori University Hospital Center “Mother Teresa” Tirana, Albania
  • Eugjen Sotiri Neuroscience Department, Psychiatric Service, Emergency Ward, University Hospital Center “Mother Teresa”, Tirana, Albania
  • Ardian Braho Neuroscience Department, Psychiatric Service, Emergency Ward, University Hospital Center “Mother Teresa”, Tirana, Albania
  • Elizana Petrela Medical University of Tirana, Statistical Department, Head of Statistic Service in University Hospital Center “Mother Teresa” Tirana Albania
Keywords: Bipolar disorder, Comparative and Randomize study, survival analysis Kaplan Meier, mood stabilizer

Abstract

Bipolar disorder is a chronic disorder, with a large diversity range of clinical manifestations that affects around 1% of total population around the world.

Objective: Evaluation of differences in efficacy between Sodium Valproate and Lithium Carbonate and Carbamazepine in maintenance treatment of patients with bipolar disorder during a 2 years follow-up period.

Design: an open comparative and randomized study.

Setting: UHC Tirana “Mother Teresa”, Psychiatric Service, Emergency Ward Participants: A total of 235 inpatient and outpatient, diagnosed with bipolar disorder I and II (at least two mood episodes) based on DSM-IV-TR. Main Outcome measures: Time survival analyses to any events (relapse/recurrence) for entire population in study, comparing three separated groups (n=60) valproate (Vp) versus lithium (Li) versus carbamazepine (Cbz).

Results: Cumulative survival of Vp was 26% higher than Cbz (p=0.001) and 4.3% than Li (p=0.4304). The mean survival time for Vp was 35 +/- 7% higher than Cbz and 10 +/- 6% higher than Li, while median time for Vp was respectively 53 +/- 7% and 14 +/- 13% higher than Cbz and Li groups. Hazard ratio of Cbz has been 108.5% higher than Vp (B=0.735, p=0.001), for Li was 20.4% higher than Vp (B=0.186).

Concerning the predictors: Vp was more effective than Li in non-classic BD I (p=0.031), also superior to Li in mixed, rapid cycling subtypes and in co-morbidities. Vp was more effective than Cbz in classic BD-I (p=0.0312).

Conclusions: Vp is significantly more effective than Cbz in long-term treatment of BD, Vp is superior than Li in non-classic form of BD.

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How to Cite
1.
Fatime Elezi, Sonila Tomori, Eugjen Sotiri, Ardian Braho, Elizana Petrela. AN OPEN COMPARATIVE AND RANDOMIZED STUDY ON VALPROATE’S EFFECT IN THE LONG-TERM TREATMENT OF BIPOLAR DISORDERS VERSUS LITHIUM CARBONATE AND CARBAMAZEPINE. Med. res. chronicles [Internet]. 2017Jun.30 [cited 2022Aug.18];4(03):230-41. Available from: https://medrech.com/index.php/medrech/article/view/237
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Original Research Article