Bipolar CHOICE (Clinical Health Outcomes Initiative in Comparative Effectiveness): a pragmatic 6-month trial of lithium versus quetiapine for bipolar disorder.

  title={Bipolar CHOICE (Clinical Health Outcomes Initiative in Comparative Effectiveness): a pragmatic 6-month trial of lithium versus quetiapine for bipolar disorder.},
  author={A. Nierenberg and S. McElroy and E. Friedman and T. Ketter and R. Shelton and T. Deckersbach and M. McInnis and C. Bowden and M. Tohen and J. Kocsis and J. Calabrese and G. Kinrys and W. Bobo and Vivek Singh and M. Kamali and D. Kemp and B. Brody and N. Reilly-Harrington and L. Sylvia and Leah W. Shesler and E. E. Bernstein and D. Schoenfeld and D. Rabideau and A. Leon and S. Faraone and M. Thase},
  journal={The Journal of clinical psychiatry},
  volume={77 1},
BACKGROUND Bipolar disorder is among the 10 most disabling medical conditions worldwide. While lithium has been used extensively for bipolar disorder since the 1970s, second-generation antipsychotics (SGAs) have supplanted lithium since 1998. To date, no randomized comparative-effectiveness study has compared lithium and any SGA. METHOD Within the duration of the study (September 2010-September 2013), participants with bipolar I or II disorder (DSM-IV-TR) were randomized for 6 months to… Expand

Paper Mentions

Interventional Clinical Trial
The purpose of this study is to compare the effectiveness of lithium and quetiapine for the treatment of individuals with bipolar disorder.  
ConditionsBipolar Disorder
Treatment of bipolar disorder: Review of evidence regarding quetiapine and lithium.
The Clinical and Health Outcomes Initiative in Comparative Effectiveness for Bipolar Disorder (Bipolar CHOICE) study was the first comparative effectiveness assessment of lithium versus quetiapine (in combination with adjunctive personalized treatment), and found no overall significant differences in efficacy and safety/tolerability outcomes. Expand
Sequential Multiple Assignment Randomized Treatment (SMART) for Bipolar Disorder at Any Phase of Illness and at least Mild Symptom Severity.
Adjunctive lamotrigine and quetiapine to either one was well-tolerated and equally effective in reducing bipolar symptomatology, but adjunctive therapy should be initiated as early as possible when depression symptoms are present. Expand
Sleep disturbance may impact treatment outcome in bipolar disorder: A preliminary investigation in the context of a large comparative effectiveness trial.
Baseline sleep disturbance was associated with more severe bipolar symptoms and worse 6-month outcomes in a randomized effectiveness trial of quetiapine and lithium. Expand
A Pilot Study of the Effectiveness of Lithium Versus Quetiapine Immediate Release Monotherapy in Patients With Bipolar Spectrum Disorders
The difference in effectiveness between lithium and quetiapine IR monotherapy in a real-world bipolar population was minimal and large-sample studies are needed to support or refute this finding. Expand
Treatment of Bipolar Disorder in a Lifetime Perspective: Is Lithium Still the Best Choice?
The available evidence indicates that bipolar disorder patients should be treated primarily with lithium, combined in some cases with antipsychotics especially in acute treatments, and sometimes, because of intolerance or inefficacy of lithium, with anticonvulsants. Expand
Efficacy and Effectiveness of Lithium in the Long-Term Treatment of Bipolar Disorders: An Update 2018.
Lithium should be using lithium more regularly right from the start for the acute treatment of a manic episode and, once remission has been achieved and euthymia maintained during continuation treatment, to regularly taper off the atypical antipsychotic, if possible, and continue with lithium as monotherapy for prophylactic treatment. Expand
A Systematic Review of Complex Polypharmacy in Bipolar Disorder: Prevalence, Clinical Features, Adherence, and Preliminary Recommendations for Practitioners.
Extensive or complex combination pharmacotherapy regimens are common in many patients with bipolar disorder and often reflect greater overall illness severity, suggesting likely confounding by indication, high severity, or comorbid conditions. Expand
Advances in the psychopharmacotherapy of bipolar disorder type I
Recent effectiveness studies continue to confirm the superiority of lithium and other mood stabilizers in the management of bipolar illness for both psychiatric and medical outcomes, reaffirming their role as foundational treatments in the Management of type I bipolar disorder. Expand
Comorbid anxiety in bipolar CHOICE: Insights from the bipolar inventory of symptoms scale.
Given its ability to identify patients with co-occurring anxiety, the BISS anxiety subscale shows clinical utility as a screening measure though its application as a clinical assessment measure may not be advisable. Expand
Challenging the Negative Perception of Lithium and Optimizing Its Long-Term Administration
The negative perception of lithium by some clinicians will be challenged and data showing lithium superiority over other MS will be presented, and the lithium-induced side effects which can make a challenge for a more frequent application of this drug will be delineated, and their proper management described. Expand