Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

106 questions · 106 findings · 4 reviews · Common Mental Disorders · Headline outcomes only

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 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 valproate

Acceptability: total withdrawals · acute mania

Lithium showed no clear difference in acceptability: total withdrawals compared with valproate (high certainty).

1 finding from 1 review
  • Lithium for acute mania 2019 · Cochrane Headline outcomes only
    OR 1.2 [0.86, 1.69]
    5 studies · 629 participants
    High

Lithium vs valproate

Adverse event: tremor · acute mania

Lithium leads to higher adverse event: tremor compared with valproate (high certainty).

1 finding from 1 review
  • Lithium for acute mania 2019 · Cochrane Headline outcomes only
    OR 10.51 [1.96, 56.48]
    2 studies · 449 participants
    High

Lithium vs valproate

Somnolence · acute mania

Lithium leads to lower adverse event: somnolence compared with valproate (high certainty).

1 finding from 1 review
  • Lithium for acute mania 2019 · Cochrane Headline outcomes only
    OR 0.47 [0.29, 0.76]
    4 studies · 575 participants
    High

Lithium vs valproate

Nausea · acute mania

Lithium showed no clear difference in adverse event: nausea compared with valproate (moderate certainty).

1 finding from 1 review
  • Lithium for acute mania 2019 · Cochrane Headline outcomes only
    OR 1.53 [0.97, 2.4]
    4 studies · 583 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: response (continuous) change in BPRS (total) from baseline to end of study ‐all data · acute mania
1 finding from 1 review
  • Lithium for acute mania 2019 · Cochrane Headline outcomes only
    no estimate extracted
    3 studies · 301 participants
    Moderate

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 lamotrigine

Acceptability: total withdrawals · acute mania

It is very uncertain whether lithium changes acceptability: total withdrawals compared with lamotrigine (very low certainty).

1 finding from 1 review
  • Lithium for acute mania 2019 · Cochrane Headline outcomes only
    OR 0.8 [0.5, 1.29]
    3 studies · 303 participants
    Very low

Lithium vs lamotrigine

Adverse event: tremor · acute mania

Lithium showed no clear difference in adverse event: tremor compared with lamotrigine (moderate certainty).

1 finding from 1 review
  • Lithium for acute mania 2019 · Cochrane Headline outcomes only
    OR 1.28 [0.48, 3.41]
    2 studies · 272 participants
    Moderate

Lithium vs placebo

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
    4 studies · 935 participants
    High

Lithium vs lamotrigine

Somnolence · acute mania

Lithium showed no clear difference in adverse event: somnolence compared with lamotrigine (moderate certainty).

1 finding from 1 review
  • Lithium for acute mania 2019 · Cochrane Headline outcomes only
    OR 1.14 [0.34, 3.85]
    2 studies · 272 participants
    Moderate

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: response (continuous) YMRS/BPRS change 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
    3 studies · 102 participants
    Very low

Lithium vs carbamazepine

Efficacy: response (continuous) CGI change 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
    2 studies · 76 participants
    Moderate

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 carbamazepine

Acceptability: total withdrawals · acute mania

Lithium showed no clear difference in acceptability: total withdrawals compared with carbamazepine (low certainty).

1 finding from 1 review

Lithium vs carbamazepine

Adverse effects: 1. Sedation · acute mania

Lithium showed no clear difference in adverse event: sedation compared with carbamazepine (low certainty).

1 finding from 1 review

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