Effect of mood stabilizers on cognition in bipolar disorder: A systematic review and meta-analysis of randomized...

Mood stabilizer therapy is a prevalent intervention for bipolar disorder (BD). This work aimed at reviewing the knowledge on the cognitive effects of mood stabilizers in patients with BD.

We systematically searched PubMed, Web of Science, Embase, Cochrane library and PsycInfo databases. Data extraction followed PRISMA guidelines, and quality assessment adhered to the Cochrane Handbook. Meta-analysis was conducted using RevMan 5.4 software.

Our meta-analysis of 570 patients from nine randomized controlled trials (RCTs) demonstrated that mood stabilizer treatments in adolescent BD patients significantly improved emotional processing accuracy (standardized mean difference [SMD] -1.18 [95 % CI = -1.69, -0.67], p < 0.00001), while prolonging reaction time (SMD -0.39 [95 % CI = -0.73, -0.05], p = 0.02). However, attention (SMD 0.21 [95 % CI = -0.16, 0.58], p = 0.27) and working memory (SMD -0.09 [95 % CI = -2.19, 2.00], p = 0.93) in adolescents, as well as overall cognitive functioning (SMD 0.48 [95 % CI = -0.49, 1.45], p = 0.33) in adults, were not significantly affected. Similarly, lithium treatment showed no significant impact on attention in adolescents (SMD 0.21 [95 % CI = -0.16, 0.58], p = 0.27) or overall cognitive functioning in adults (SMD 0.43 [95 % CI = -0.50, 1.35], p = 0.37).

Mood stabilizer treatments may enhance emotional processing accuracy while extending reaction times in adolescents, without compromising overall cognitive functioning or specific cognitive domains. Further research is warranted to substantiate these preliminary findings.