Response to lithium and anticonvulsants among patients with bipolar disorder with and without comorbid epilepsy – A nation-wide population-based longitudinal study
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Response to lithium and anticonvulsants among patients with bipolar disorder with and without comorbid epilepsy – A nation-wide population-based longitudinal study. / Kessing, Lars Vedel; Ziersen, Simon Christoffer; Gerds, Thomas; Budtz-Jørgensen, Esben.
In: Journal of Affective Disorders, Vol. 308, 2022, p. 369-374.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Response to lithium and anticonvulsants among patients with bipolar disorder with and without comorbid epilepsy – A nation-wide population-based longitudinal study
AU - Kessing, Lars Vedel
AU - Ziersen, Simon Christoffer
AU - Gerds, Thomas
AU - Budtz-Jørgensen, Esben
N1 - Publisher Copyright: © 2022
PY - 2022
Y1 - 2022
N2 - Objective: In a nation-wide population-based longitudinal register linkage study for the first time 1) to investigate long-term response to lithium in patients with bipolar disorder with and without comorbid epilepsy, and 2) within patients with bipolar disorder and comorbid epilepsy to compare differences in responses between lithium, valproate and lamotrigine. Methods: We used Danish nation-wide population-based longitudinal register linkage to identify 154 patients with bipolar disorder and comorbid epilepsy and 8381 patients with bipolar disorder without comorbid epilepsy during a study period from 1995 to 2017. Response was defined as continuous monotherapy with lithium, valproate or lamotrigine without switch to or add-on of an antipsychotic drug or an antidepressant or hospitalization during an up to ten-year follow-up period. We calculated standardized absolute risks and differences thereof with respect to age, gender, socioeconomic status and comorbidity with other physical disorders than epilepsy. Results: Response to lithium was decreased in patients with bipolar disorder with versus without comorbid epilepsy during the ten-year follow-up period and the difference remained after standardization for comorbidity with other physical disorders than epilepsy. Within patients with bipolar disorder and comorbid epilepsy, response to lithium was decreased compared with responses to valproate and lamotrigine. Conclusions: The findings suggest that valproate and lamotrigine should be given priority in patients with comorbid bipolar disorder and epilepsy. The study highlights the need for closely clinical monitoring and psychological support for patients with bipolar disorder and comorbid epilepsy and emphasize the need for further long-term studies of effect of interventions.
AB - Objective: In a nation-wide population-based longitudinal register linkage study for the first time 1) to investigate long-term response to lithium in patients with bipolar disorder with and without comorbid epilepsy, and 2) within patients with bipolar disorder and comorbid epilepsy to compare differences in responses between lithium, valproate and lamotrigine. Methods: We used Danish nation-wide population-based longitudinal register linkage to identify 154 patients with bipolar disorder and comorbid epilepsy and 8381 patients with bipolar disorder without comorbid epilepsy during a study period from 1995 to 2017. Response was defined as continuous monotherapy with lithium, valproate or lamotrigine without switch to or add-on of an antipsychotic drug or an antidepressant or hospitalization during an up to ten-year follow-up period. We calculated standardized absolute risks and differences thereof with respect to age, gender, socioeconomic status and comorbidity with other physical disorders than epilepsy. Results: Response to lithium was decreased in patients with bipolar disorder with versus without comorbid epilepsy during the ten-year follow-up period and the difference remained after standardization for comorbidity with other physical disorders than epilepsy. Within patients with bipolar disorder and comorbid epilepsy, response to lithium was decreased compared with responses to valproate and lamotrigine. Conclusions: The findings suggest that valproate and lamotrigine should be given priority in patients with comorbid bipolar disorder and epilepsy. The study highlights the need for closely clinical monitoring and psychological support for patients with bipolar disorder and comorbid epilepsy and emphasize the need for further long-term studies of effect of interventions.
KW - Bipolar disorder
KW - Comorbid
KW - Epilepsy
KW - Lamotrigine
KW - lithium
KW - Valproate
U2 - 10.1016/j.jad.2022.04.098
DO - 10.1016/j.jad.2022.04.098
M3 - Journal article
C2 - 35460731
AN - SCOPUS:85128968546
VL - 308
SP - 369
EP - 374
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
SN - 0165-0327
ER -
ID: 308891041