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Bipolar disorder patients treated with lithium appear to have a reduced rate of dementia compared with patients who receive anticonvulsants, antidepressants, or antipsychotics, the results of a Danish study indicate.
It has been suggested that patients with bipolar disorder have an increased risk for dementia that increases with each affective episode. While it also seems that lithium may have neuroprotective effects, the results have so far been conflicting.
To investigate further, Lars Kessing, from the University Hospital of Copenhagen, and colleagues studied 4856 patients discharged from psychiatric healthcare services with a diagnosis of mania or bipolar disorder between 1995 and 2005, of whom 216 (4.5%) were diagnosed with dementia.
In all, 50.4% patients were exposed to lithium, 36.7% were exposed to anticonvulsants, 88.1% to antidepressants, and 80.3% to antipsychotics. Only 0.7% of patients were exposed to lithium alone.
Adjusting for age, gender, calendar period, and purchasing of and exposure to the other drugs, two or more prescriptions of lithium was associated with a significant decrease in the rate of dementia, at rate ratios for 2??”4, 5??”9, 10??”19, and ?20 prescriptions of 0.46, 0.38, 0.39, and 0.44, respectively, compared with one prescription for lithium.
In contrast, no associations between number of prescriptions and the rate of dementia were found for the other drugs groups studied, the researchers note in the journal Bipolar Disorders.
They say: “Among patients with mania or bipolar disorder, continued use of lithium was associated with a decreased rate of dementia.”
However, the team adds: “Methodologic reasons for these findings cannot be excluded due to the nonrandomized nature of the data.”
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010
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