Immediate-release vs. prolonged-release lithium formulations in bipolar disorder: a 2-year comparative study.

IF 2.1 3区医学 Q3 PHARMACOLOGY & PHARMACY

International Clinical Psychopharmacology Pub Date : 2025-02-19 DOI:10.1097/YIC.0000000000000584

Margherita Barbuti, Martina Moriconi, Daria Bartolini, Ugo De Rosa, Camilla Elefante, Elisa Schiavi, Giulio Perugi

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Abstract

The aim of this study is to evaluate the therapeutic outcomes, tolerability, and adherence to immediate-release (IR) and prolonged-release (PR) lithium formulations in patients with bipolar disorder (BD) over a 2-year follow-up. This naturalistic study included 143 BD patients who initiated IR (48%) or PR (52%) lithium treatment at the inpatient and outpatient services of the University Hospital of Pisa. During follow-up, data were collected on side effects, treatment adherence, blood lithium levels, and creatinine and thyroid stimulating hormone concentrations. Clinical efficacy and functioning were assessed using the Clinical Global Impressions for Bipolar Disorder and Functioning Assessment Short Test scales. Approximately 50% of patients completed the 2-year follow-up, with similar dropout rates between the two groups. Both groups showed significant clinical improvement with comparable efficacy. PR lithium, however, was associated with fewer side effects, particularly tremors and gastrointestinal issues, leading to better adherence. Additionally, PR lithium administration resulted in more stable blood lithium levels. Despite its limitations, including the observational design, potential confounders such as concomitant medications, and a high dropout rate, these findings suggest that PR lithium formulations provide similar clinical efficacy to IR formulations but offer superior tolerability. Therefore, PR lithium represents a favorable option for improving adherence, particularly in patients at risk of treatment discontinuation.

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双相情感障碍的速释与缓释锂制剂：一项为期2年的比较研究。

本研究的目的是在为期2年的随访中评估双相情感障碍（BD）患者的治疗结果、耐受性和对即释（IR）和缓释（PR）锂制剂的依从性。这项自然研究包括143名在比萨大学医院住院和门诊接受IR（48%）或PR（52%）锂治疗的BD患者。在随访期间，收集了副作用、治疗依从性、血锂水平、肌酐和促甲状腺激素浓度的数据。使用双相情感障碍临床总体印象和功能评估短测试量表评估临床疗效和功能。大约50%的患者完成了2年的随访，两组之间的退出率相似。两组临床均有显著改善，疗效相当。然而，PR锂的副作用较少，特别是震颤和胃肠道问题，因此依从性更好。此外，PR锂管理导致更稳定的血锂水平。尽管其局限性，包括观察性设计、潜在的混杂因素（如伴随用药）和高辍学率，这些发现表明PR锂制剂与IR制剂具有相似的临床疗效，但具有更好的耐受性。因此，PR锂是改善依从性的一个有利选择，特别是对于有停药风险的患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Clinical Psychopharmacology 医学-精神病学

CiteScore

4.40

自引率

23.10%

发文量

审稿时长

>12 weeks

期刊介绍： International Clinical Psychopharmacology provides an essential link between research and clinical practice throughout psychopharmacology. It reports on studies in human subjects, both healthy volunteers and patients, which relate the effects of drugs on psychological processes. A major objective of the journal is to publish fully refereed papers which throw light on the ways in which the study of psychotropic drugs can increase our understanding of psychopharmacology. To this end the journal publishes results of early Phase I and II studies, as well as those of controlled clinical trials of psychotropic drugs in Phase II and IV. Other topics covered include the epidemiology of psychotropic drug prescribing and drug taking, the sociology of psychotropic drugs including compliance, and research into the safety and adverse effects of these compounds.