Individual research recommendation details

Recommendation ID

CG185/2

Question

Maintenance treatment:- In the maintenance treatment of bipolar disorder, what is the relative effect on quality of life of lithium, an antipsychotic (haloperidol, olanzapine, quetiapine or risperidone), or a combination of lithium and an antipsychotic?

Any explanatory notes
(if applicable)

Lithium and antipsychotic medication are known to reduce the risk of relapse when used long-term in people with bipolar disorder. Relapses do still occur and the response is usually to add another mood-stabilising drug. However, lithium and antipsychotics are associated with a number of side effects, some of which can adversely affect physical health. The relative effects of lithium, an antipsychotic or a combination of these drugs, regarding efficacy, tolerability, cost effectiveness and quality of life, are unknown. Such information is important to people with bipolar disorder to help them make an informed choice about the treatment options available to them, and to the NHS to inform the best use of resources. The suggested programme of research should involve a pragmatic 3-arm RCT comparing lithium monotherapy with antipsychotic monotherapy (haloperidol, olanzapine, quetiapine or risperidone) and a combination of lithium and an antipsychotic. The study should last at least 1 year with the
primary outcome being quality of life. Symptom control, relapse, function and economic outcomes should also be measured.

Source guidance details

Comes from guidance

Bipolar disorder: assessment and management

Number

CG185

Date issued

September 2014

Other details