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Evidence found and GRADE certainty

106 questions · 106 findings · 4 reviews · Common Mental Disorders

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No studies found 29 · 27.4%GRADE not reported 5 · 4.7%Very low 18 · 17%Low 16 · 15.1%Moderate 25 · 23.6%High 13 · 12.3%

Lithium vs valproate

Efficacy: response (continuous) Change in YMRS (ITT‐LOCF) from baseline to end of study · acute mania
1 finding from 1 review
  • Lithium for acute mania 2019 · Cochrane Headline outcomes only
    no estimate extracted
    5 studies · 398 participants
    Very low

Mood stabilisers vs placebo

Repetition of SH at post‐intervention · self‐harm in adults

It is very uncertain whether mood stabilisers, including antiepileptics and lithium changes repetition of SH by post‐intervention№ of participants: 167(1 RCT) compared with placebo (very low certainty).

1 finding from 1 review

Lamotrigine vs lithium

Recurrence of any episodes at one year (Young Mania Rating Scale (YMRS) total score ≥15 for manic episode) · bipolar disorder

It is very uncertain whether lamotrigine changes recurrence of any episodes at one year (Young Mania Rating Scale… compared with lithium (very low certainty).

1 finding from 1 review

Lamotrigine vs lithium

Recurrence of any episodes at one year (Montgomery‐Asberg Depression Rating Scale (MADRS) total score ≥15 for depressive episode; Hamilton Depression Rating Scale (HDRS) total score ≥14 for depressive episode) · bipolar disorder

Lamotrigine showed no clear difference in recurrence of any episodes at one year (Montgomery‐Asberg Depression… compared with lithium (low certainty).

1 finding from 1 review

Lamotrigine vs lithium

Recurrence of any episodes at one year for clinical worsening with additional psychotropics (mood stabilizers, antidepressants, antipsychotics or benzodiazepines) · bipolar disorder

Lamotrigine showed no clear difference in recurrence of any episodes at one year for clinical worsening with… compared with lithium (moderate certainty).

1 finding from 1 review

Lamotrigine vs lithium

Recurrence of any episodes at one year (active suicidal behavior) · bipolar disorder

It is very uncertain whether lamotrigine changes recurrence of any episodes at one year (active suicidal behavior) compared with lithium (very low certainty).

1 finding from 1 review

Lamotrigine vs lithium

Withdrawal from treatment due to any reason, 6‐12 months after intervention initiation (long term) · bipolar disorder

Lamotrigine showed no clear difference in withdrawal from treatment due to any reason, 6‐12 months after… compared with lithium (moderate certainty).

1 finding from 1 review

Lamotrigine vs lithium

Any reported adverse effects 6‐12 months after initiating the intervention (long term) · bipolar disorder

Lamotrigine probably leads to lower any reported adverse effects 6‐12 months after initiating the… compared with lithium (moderate certainty).

1 finding from 1 review

Valproate vs lithium

Response rate at 3 weeks (primary efficacy outcome) · Adults (aged 18 and over) with acute mania

Valproate showed no clear difference in response rate at 3 weeks (primary efficacy outcome) compared with lithium (moderate certainty).

1 finding from 1 review

Valproate vs lithium

Primary outcome 3: Adverse events · Adults (aged 18 and over) with acute mania

Valproate showed no clear difference in number of participants with any adverse event at 2‐4 weeks (primary… compared with lithium (low certainty).

1 finding from 1 review

Valproate vs lithium

Adverse effects: 1. Sedation · Adults (aged 18 and over) with acute mania

Valproate showed no clear difference in individual adverse events ‐ Sedation At 3 weeks (secondary… compared with lithium (low certainty).

1 finding from 1 review

Valproate vs lithium

Change in symptom severity at 3 weeks (secondary efficacy outcome) · Adults (aged 18 and over) with acute mania
1 finding from 1 review