Dept of Psychiatry Presentor- Dr. Nilesh BasarkarModerator- Dr. C Pinto , Dr. J P Rawat Dr. Malay Dave
Valproate v. Lithium in the treatment of Bipolar disorder in clinical practice The British Journal of Psychiatry 2011 Lars Vedel Kessing Gunnar Hellmund John R. Geddes Guy M. Goodwin Per Kragh Andersen
Introduction Bipolar disorder – Complex heterogeneous recurrent episodic illness.Valproate – most commonly used mood stabilizer.
Aims and ObjectivesTo compare the effect of Valproate V. Lithium for treatment in Bipolar disorder in clinical practice.
MethodologyObservational Cohort Study in DenmarkDiagnosed cases of Bipolar disorderOn Valproate or LithiumPeriod – 1995 - 2006
Exclusion criteria• Anti depressants• Anti psychotics• Anti convulsants other than Valproate at the time of study
Analysis was adjusted for• Gender ( M / F )• Age group – all age in 5 year interval , upto 24years, 25-29, 30- 34, etc. upto 60-64, 65+• Purchase of Anti depressants, Anti psychotics or Anti convulsants prior to purchase of Lithium or Valproate• Previous hospital admissions
Analysis were carried out for four sub populations• Bipolar disorder – current episode Depression Hypo manic or Manic Mixed Remission
ObservationGender distribution and age at first purchase of Lithium and Valproate seen to be indistinguishable .