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Global Multi-Site Study Comparing Medications for Bipolar Disorder to be Presented at International Conference in Pittsburgh

PITTSBURGH, June 26 People with bipolar disorder stay free of symptoms longer when they are treated with a combination of mood stabilizing drugs rather than just one, according to an international research study.

Using both lithium and divalproex reduced the rate of relapse compared to either drug alone, said principal investigator John Geddes, M.D., professor of epidemiological psychiatry, Department of Psychiatry, University of Oxford, and principal investigator of the study. He will present the preliminary results at the Eighth International Conference on Bipolar Disorder, Saturday, June 27, David L. Lawrence Convention Center, Pittsburgh.

“Until now, there haven’t been many studies that compare combination therapy with monotherapies,” Dr. Geddes said. “A large proportion of patients have been prescribed two or more drugs to control their symptoms, but there was limited evidence supporting that practice.”

It’s not unusual for a doctor to start a patient with bipolar illness on one drug and then add another one to get a better response, he added. But the current findings indicate the more effective approach is to initiate treatment with two drugs, regardless of the severity of the patient’s symptoms when they first became ill.

In BALANCE, which stands for Bipolar Affective disorder: Lithium/ANti-Convulsant Evaluation, 330 people who were being treated for bipolar disorder for the first time were randomly assigned to receive lithium, divalproex or both drugs. The combination treatment reduced the risk of a new illness episode by 18 percent when compared to lithium monotherapy, and by 41 percent compared to divalproex monotherapy.

“This trial had a simple design and was not expensive to do,” Dr. Geddes noted. “It points to practical ways to answer many important clinical questions without costing an arm and leg.”

In addition to being director of the Oxford Clinical Trials Unit for Mental Illness, Dr. Geddes is an honorary consultant psychiatrist at the Oxfordshire and Buckinghamshire Mental Health NHS Foundation Trust, where he provides clinical care for patients with mood disorders; a Fellow of the Royal College of Psychiatrists; the recipient of an honorary fellowship of the American College of Psychiatrists in 2008; and author or co-author of more than 150 scientific articles and book chapters and four books.

The BALANCE study was funded and supported by the Stanley Medical Research Institute, based in Chevy Chase, Md., and Sanofi-Aventis.

The Eighth International Conference on Bipolar Disorder, which is sponsored by the University of Pittsburgh School of Medicine and Western Psychiatric Institute and Clinic of UPMC, is the only venue in the world devoted exclusively to highlighting new research into bipolar disorder. The disease affects both adults and children, devastates families and work relationships, accounts for nearly half of all suicides in the United States and costs billions in medical bills, missed work and lower productivity.

For more information on the meeting, visit www.8thbipolar.org.

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