Abstract

Objective: While prescription of lithium has been limited in recent years due to its adverse effects and necessity for frequent laboratory tests, second generation antipsychotics (SGAs) are introduced as helpful medications for acute and maintenance treatment of bipolar disorder. Comparing lithium with aripiprazole in a group of patients with diagnosis of acute mania was the objective of the present trial.

Methods: 30 male inpatients with diagnosis of bipolar I disorder were entered into a four-week, doubleblind study for random assignment to lithium carbonate (800-1200mg/day) or aripiprazole (20-30mg/ day) (n=15 in each group). While Manic State Rating Scale (MSRS) was the main outcome measure in the present assessment, other scales such as Bech-Rafaelsen Mania Scale (BRMS), Schedule for Assessment of Insight (SAI) and Clinical Global Impressions-Global Improvement scale (CGI-G) have been used as secondary outcome measures.

Results: While at the end of assessment and in comparison with baseline frequency and intensity of symptoms reduced significantly in both groups (p<0.05), improvement was significantly more remarkable by lithium compared with aripiprazole (p<0.01). Also, while CGI-G demonstrated significant improvement by both of them (p< 0.04 for aripiprazole & p< 0.002 for lithium), BRMS and SAI showed significant amelioration only in the lithium group (p<0.001& p<0.000, respectively).

Conclusion: Though both aripiprazole and lithium were helpful for improvement of manic symptoms, treatment with lithium was more advantageous.

Keywords: Bipolar disorder; Acute mania; Lithium; Aripiprazole