Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

30 questions · 30 findings · 1 reviews · Headline outcomes only

No studies found 16 · 53.3%GRADE not reported 0 · 0%Very low 2 · 6.7%Low 3 · 10%Moderate 4 · 13.3%High 5 · 16.7%

Lithium vs placebo

Efficacy: response (categorical) MSRS/YMRS ≥ 50% decrease in score by end of study · acute mania

Lithium leads to higher efficacy: response (categorical) YMRS/MRS decrease by ≥ 50% at end… compared with placebo (high certainty).

1 finding from 1 review
  • Lithium for acute mania 2019 · Cochrane Headline outcomes only
    OR 2.13 [1.73, 2.63]
    6 studies · 1707 participants
    High

Lithium vs valproate

Efficacy: remission (categorical) YMRS ≤ 12 and no increase in MADRS at end of study · acute mania

Lithium showed no clear difference in efficacy: remission (categorical) YMRS ≤ 12 and no increase in MADRS… compared with valproate (moderate certainty).

1 finding from 1 review
  • Lithium for acute mania 2019 · Cochrane Headline outcomes only
    OR 0.78 [0.46, 1.32]
    1 study · 257 participants
    Moderate

Lithium vs lamotrigine

Efficacy: response (categorical) YMRS/SADS‐C decrease ≥ 50% by end of study · acute mania

The review found no eligible studies for this question.

1 finding from 1 review
  • Lithium for acute mania 2019 · Cochrane Headline outcomes only
    no estimate extracted
    Studies not reported
    No studies found

Lithium vs lamotrigine

Efficacy: remission (categorical) YMRS ≤ 12 and no increase in MADRS at end of study · acute mania

The review found no eligible studies for this question.

1 finding from 1 review
  • Lithium for acute mania 2019 · Cochrane Headline outcomes only
    no estimate extracted
    Studies not reported
    No studies found

Lithium vs carbamazepine

Efficacy: response (categorical) YMRS/SADS‐C decrease ≥ 50% by end of study · acute mania

The review found no eligible studies for this question.

1 finding from 1 review
  • Lithium for acute mania 2019 · Cochrane Headline outcomes only
    no estimate extracted
    Studies not reported
    No studies found

Lithium vs carbamazepine

Efficacy: remission (categorical) YMRS ≤ 12 and no increase in MADRS at end of study · acute mania

The review found no eligible studies for this question.

1 finding from 1 review
  • Lithium for acute mania 2019 · Cochrane Headline outcomes only
    no estimate extracted
    Studies not reported
    No studies found

Lithium vs QUETIAPINE

Efficacy: response (categorical) YMRS change ≥ 50% from baseline to end of study · acute mania

It is very uncertain whether lithium changes efficacy: response (categorical) YMRS decrease by ≥ 50% by end of… compared with quetiapine (very low certainty).

1 finding from 1 review
  • Lithium for acute mania 2019 · Cochrane Headline outcomes only
    OR 0.66 [0.28, 1.55]
    2 studies · 335 participants
    Very low

Lithium vs QUETIAPINE

Remission · acute mania

Lithium showed no clear difference in efficacy: remission (categorical) Decrease in YMRS ≤ 12 by end of… compared with quetiapine (low certainty).

1 finding from 1 review
  • Lithium for acute mania 2019 · Cochrane Headline outcomes only
    OR 0.64 [0.26, 1.57]
    2 studies · 359 participants
    Low

Lithium vs placebo

Remission · acute mania

Lithium leads to higher efficacy: remission (categorical) YMRS < 12 at end of study compared with placebo (high certainty).

1 finding from 1 review
  • Lithium for acute mania 2019 · Cochrane Headline outcomes only
    OR 2.16 [1.73, 2.69]
    5 studies · 1597 participants
    High

Lithium vs OLANZAPINE

Efficacy: response (categorical) MSRS/YMRS ≥ 50% decrease in score by end of study · acute mania

Lithium probably leads to lower efficacy: response (categorical) MSRS/YMRS ≥ 50% decrease in score… compared with olanzapine (moderate certainty).

1 finding from 1 review
  • Lithium for acute mania 2019 · Cochrane Headline outcomes only
    OR 0.44 [0.2, 0.94]
    2 studies · 180 participants
    Moderate

Lithium vs OLANZAPINE

Remission · acute mania

Lithium showed no clear difference in efficacy: remission (categorical) YMRS ≤ 12 at end of study compared with olanzapine (low certainty).

1 finding from 1 review

Lithium vs chlorpromazine

Efficacy: response (categorical) MSRS/YMRS ≥ 50% decrease in score by end of study · acute mania

The review found no eligible studies for this question.

1 finding from 1 review
  • Lithium for acute mania 2019 · Cochrane Headline outcomes only
    no estimate extracted
    Studies not reported
    No studies found

Lithium vs chlorpromazine

Remission · acute mania

The review found no eligible studies for this question.

1 finding from 1 review
  • Lithium for acute mania 2019 · Cochrane Headline outcomes only
    no estimate extracted
    Studies not reported
    No studies found

Lithium vs haloperidol

Efficacy: response (categorical) MSRS/YMRS ≥ 50% decrease in score by end of study · acute mania

The review found no eligible studies for this question.

1 finding from 1 review
  • Lithium for acute mania 2019 · Cochrane Headline outcomes only
    no estimate extracted
    Studies not reported
    No studies found

Lithium vs haloperidol

Remission · acute mania

The review found no eligible studies for this question.

1 finding from 1 review
  • Lithium for acute mania 2019 · Cochrane Headline outcomes only
    no estimate extracted
    Studies not reported
    No studies found

Lithium vs Zuclopenthixol (Cis Z/Trans E isomer)

Efficacy: response (categorical) BMRS change ≥ 50% from baseline to end of study · acute mania

It is very uncertain whether lithium changes efficacy: response (categorical) BMRS change ≥ 50% from baseline to… compared with zuclopenthixol (very low certainty).

1 finding from 1 review
  • Lithium for acute mania 2019 · Cochrane Headline outcomes only
    OR 1.33 [0.3, 5.91]
    1 study · 28 participants
    Very low

Lithium vs RISPERIDONE

Efficacy: response (categorical) BMRS change ≥ 50% from baseline to end of study · acute mania

The review found no eligible studies for this question.

1 finding from 1 review
  • Lithium for acute mania 2019 · Cochrane Headline outcomes only
    no estimate extracted
    Studies not reported
    No studies found

Lithium vs RISPERIDONE

Efficacy: remission (categorical) YMRS ≤ 12/absence of DSM‐IV mania by end of study · acute mania

Lithium showed no clear difference in efficacy: remission (categorical) YMRS ≤ 12/absence of DSM‐IV mania… compared with risperidone (low certainty).

1 finding from 1 review
  • Lithium for acute mania 2019 · Cochrane Headline outcomes only
    OR 1.3 [0.11, 14.95]
    2 studies · 211 participants
    Low

Lithium vs ARIPIPRAZOLE

Efficacy: response (categorical) BMRS change ≥ 50% from baseline to end of study · acute mania

The review found no eligible studies for this question.

1 finding from 1 review
  • Lithium for acute mania 2019 · Cochrane Headline outcomes only
    no estimate extracted
    Studies not reported
    No studies found