GERI-BD: A Randomized Double-Blind Controlled Trial of Lithium and Divalproex in the Treatment of Mania in Older Patients With Bipolar Disorder

The American Journal of Psychiatry
Robert C YoungGERI-BD Study Group

Abstract

Clinicians treating older patients with bipolar disorder with mood stabilizers need evidence from age-specific randomized controlled trials. The authors describe findings from a first such study of late-life mania. The authors compared the tolerability and efficacy of lithium carbonate and divalproex in 224 inpatients and outpatients age 60 or older with bipolar I disorder who presented with a manic, hypomanic, or mixed episode. Participants were randomly assigned, under double-blind conditions, to treatment with lithium (target serum concentration, 0.80-0.99 mEq/L) or divalproex (target serum valproate concentration, 80-99 μg/mL) for 9 weeks. Participants with an inadequate response after 3 weeks received open adjunctive risperidone. The authors hypothesized that divalproex would be better tolerated and more efficacious than lithium. Tolerability was assessed based on a measure of sedation and on the proportions of participants achieving target concentrations. Efficacy was assessed with the Young Mania Rating Scale (YMRS). Attrition rates were similar for lithium and divalproex (14% and 18% at week 3 and 51% and 44% at week 9, respectively). The groups did not differ significantly in sedation. Participants in the lithium group...Continue Reading

Associated Clinical Trials

Citations

Feb 14, 2019·Australasian Psychiatry : Bulletin of Royal Australian and New Zealand College of Psychiatrists·Ahmed Naguy, Tarek M Shoukry
Jun 4, 2019·The Cochrane Database of Systematic Reviews·Rebecca F McKnightAndrea Cipriani
Oct 18, 2019·The Cochrane Database of Systematic Reviews·Janina JochimAndrea Cipriani
Dec 5, 2017·International Review of Psychiatry·Liana K MathiasBrent P Forester
Jan 8, 2019·Drugs & Aging·Jocelyn Fotso SohSoham Rej
May 28, 2020·Frontiers in Psychiatry·Constantin VolkmannStephan Köhler
May 22, 2020·International Journal of Bipolar Disorders·Andrea MurruUNKNOWN International Group for The Study of Lithium Treated Patients (IGSLi)
Sep 30, 2018·Zeitschrift für Gerontologie und Geriatrie·Jens Benninghoff, Peter Brieger
Dec 18, 2020·Frontiers in Psychiatry·Delfina JaniriAnna Rita Bentivoglio
Feb 23, 2021·Expert Opinion on Pharmacotherapy·Ahmad Sleem, Rif S El-Mallakh
Jun 2, 2021·The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry·D P DevanandGregory H Pelton
Jul 3, 2021·Medicina·Ivan ArnoldArmand Hausmann
Sep 23, 2021·Annals of General Psychiatry·Nemanja LjubicHans-Jörg Assion

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Methods Mentioned

BETA
Pharmacotherapy
sedation

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