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Acute antidepressive efficacy of lithium monotherapy, not citalopram, depends on recurrent course of depression.
J Clin Psychopharmacol. 2013 Feb; 33(1):38-44.JC

Abstract

Studies of the 1970s and 1980s showed lithium monotherapy to be an effective treatment of acute unipolar major depressive disorder (MDD) and hence as a potential alternative to monoaminergic antidepressants.The objective was to conduct the first comparison of a lithium monotherapy with a modern antidepressant in the acute treatment of MDD. Results were compared with citalopram's efficacy as shown in a different but methodologically identical study (including same researchers, same time, and same place).Thirty patients with an acute MDD (Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition [DSM IV] I) were treated with lithium monotherapy (study 1) or with citalopram monotherapy (study 2, N = 32) for 4 weeks.Response rates (decrease in Hamilton Depression Rating Scale score >50%) were 50% for lithium and 72% for citalopram (P = 0.12). Citalopram-treated subjects showed a greater decrease in Hamilton Depression Rating Scale scores (significant at 2 weeks). In the lithium study, only patients with a recurrent episode (DSM-IV: 296.3) responded (15/22), as opposed to none of 8 patients with a first/single episode (DSM-IV: 296.2) (P = 0.002). Patients with a single episode responded significantly more often to citalopram than to lithium (P = 0.007). Both drugs were well tolerated. Only one patient (citalopram) terminated the study prematurely owing to adverse effects.Our results do not support the use of lithium as an alternative to SSRI in the treatment of acute MDD. The finding of a better response to lithium in patients with a recurrent depression has not been reported before and warrants replication. The comparison is limited by the lack of a randomized double-blind design.

Authors+Show Affiliations

Department of Psychiatry, Schlosspark-Clinic, Berlin, Germany. bschor@schlosspark-klinik.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23277245

Citation

Bschor, Tom, et al. "Acute Antidepressive Efficacy of Lithium Monotherapy, Not Citalopram, Depends On Recurrent Course of Depression." Journal of Clinical Psychopharmacology, vol. 33, no. 1, 2013, pp. 38-44.
Bschor T, Uhr M, Baethge C, et al. Acute antidepressive efficacy of lithium monotherapy, not citalopram, depends on recurrent course of depression. J Clin Psychopharmacol. 2013;33(1):38-44.
Bschor, T., Uhr, M., Baethge, C., Lewitzka, U., Ising, M., Erbe, S., Winkelmann, P., & Ritter, D. (2013). Acute antidepressive efficacy of lithium monotherapy, not citalopram, depends on recurrent course of depression. Journal of Clinical Psychopharmacology, 33(1), 38-44. https://doi.org/10.1097/JCP.0b013e31827b9495
Bschor T, et al. Acute Antidepressive Efficacy of Lithium Monotherapy, Not Citalopram, Depends On Recurrent Course of Depression. J Clin Psychopharmacol. 2013;33(1):38-44. PubMed PMID: 23277245.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acute antidepressive efficacy of lithium monotherapy, not citalopram, depends on recurrent course of depression. AU - Bschor,Tom, AU - Uhr,Manfred, AU - Baethge,Christopher, AU - Lewitzka,Ute, AU - Ising,Marcus, AU - Erbe,Sebastian, AU - Winkelmann,Patricia, AU - Ritter,Dirk, PY - 2013/1/2/entrez PY - 2013/1/2/pubmed PY - 2013/6/13/medline SP - 38 EP - 44 JF - Journal of clinical psychopharmacology JO - J Clin Psychopharmacol VL - 33 IS - 1 N2 - Studies of the 1970s and 1980s showed lithium monotherapy to be an effective treatment of acute unipolar major depressive disorder (MDD) and hence as a potential alternative to monoaminergic antidepressants.The objective was to conduct the first comparison of a lithium monotherapy with a modern antidepressant in the acute treatment of MDD. Results were compared with citalopram's efficacy as shown in a different but methodologically identical study (including same researchers, same time, and same place).Thirty patients with an acute MDD (Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition [DSM IV] I) were treated with lithium monotherapy (study 1) or with citalopram monotherapy (study 2, N = 32) for 4 weeks.Response rates (decrease in Hamilton Depression Rating Scale score >50%) were 50% for lithium and 72% for citalopram (P = 0.12). Citalopram-treated subjects showed a greater decrease in Hamilton Depression Rating Scale scores (significant at 2 weeks). In the lithium study, only patients with a recurrent episode (DSM-IV: 296.3) responded (15/22), as opposed to none of 8 patients with a first/single episode (DSM-IV: 296.2) (P = 0.002). Patients with a single episode responded significantly more often to citalopram than to lithium (P = 0.007). Both drugs were well tolerated. Only one patient (citalopram) terminated the study prematurely owing to adverse effects.Our results do not support the use of lithium as an alternative to SSRI in the treatment of acute MDD. The finding of a better response to lithium in patients with a recurrent depression has not been reported before and warrants replication. The comparison is limited by the lack of a randomized double-blind design. SN - 1533-712X UR - https://www.unboundmedicine.com/medline/citation/23277245/Acute_antidepressive_efficacy_of_lithium_monotherapy_not_citalopram_depends_on_recurrent_course_of_depression_ L2 - http://dx.doi.org/10.1097/JCP.0b013e31827b9495 DB - PRIME DP - Unbound Medicine ER -