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Immediate-release vs. prolonged-release lithium formulations in bipolar disorder: a 2-year comparative study
Margherita Barbuti1, Martina Moriconi1, Daria Bartolini1
1Psychiatry Unit 2, Department of Clinical and Experimental Medicine, University of Pisa.
International Clinical Psychopharmacology
|February 18, 2025
Summary
This study compared immediate-release (IR) and prolonged-release (PR) lithium for bipolar disorder (BD). PR lithium showed similar efficacy to IR lithium but with better tolerability and adherence, suggesting it
Area of Science:
- Psychiatry and Pharmacology
- Neuroscience and Mental Health
Background:
- Lithium is a cornerstone mood stabilizer for bipolar disorder (BD).
- Optimizing lithium formulations is crucial for long-term treatment adherence and tolerability in BD patients.
Purpose of the Study:
- To compare therapeutic outcomes, tolerability, and adherence between immediate-release (IR) and prolonged-release (PR) lithium formulations in bipolar disorder patients.
- To evaluate the 2-year clinical efficacy and safety profile of IR versus PR lithium.
Main Methods:
- A naturalistic study involving 143 bipolar disorder patients initiating either IR or PR lithium treatment.
- Data collection included side effects, adherence, blood lithium levels, and clinical assessments (CGI-Bipolar, FAST) over a 2-year follow-up.
- Analysis compared outcomes between the two lithium formulations, acknowledging limitations like observational design and potential confounders.
Main Results:
- Both IR and PR lithium groups demonstrated significant clinical improvement with comparable efficacy.
- PR lithium exhibited superior tolerability, with fewer reported side effects (e.g., tremors, gastrointestinal issues) compared to IR lithium.
- Patients on PR lithium showed better treatment adherence and more stable blood lithium level monitoring.
Conclusions:
- Prolonged-release (PR) lithium formulations offer comparable clinical efficacy to immediate-release (IR) lithium for bipolar disorder.
- PR lithium provides enhanced tolerability and improved patient adherence, making it a favorable option, especially for those at risk of discontinuation.
- The findings support PR lithium as a valuable alternative for managing bipolar disorder, potentially improving long-term treatment success.
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