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A single-blind, randomised controlled trial on the effects of lithium and quetiapine monotherapy on the trajectory of cognitive functioning in first episode mania: A 12-month follow-up study

Published online by Cambridge University Press:  23 March 2020

R. Daglas ,
S.M. Cotton ,
K. Allott ,
M. Yücel ,
C.A. Macneil ,
M.K. Hasty ,
B. Murphy ,
C. Pantelis ,
K.T. Hallam  and
L.P. Henry
...Show all authors
R. Daglas*
Affiliation:
Orygen, The National Centre of Excellence in Youth Mental Health, Locked Bag 10 (35, Poplar Road), Parkville Victoria, 3052, Australia Centre for Youth Mental Health, University of Melbourne, 35 Poplar Road, Parkville Victoria, 3052, Australia
S.M. Cotton
Affiliation:
Orygen, The National Centre of Excellence in Youth Mental Health, Locked Bag 10 (35, Poplar Road), Parkville Victoria, 3052, Australia Centre for Youth Mental Health, University of Melbourne, 35 Poplar Road, Parkville Victoria, 3052, Australia
K. Allott
Affiliation:
Orygen, The National Centre of Excellence in Youth Mental Health, Locked Bag 10 (35, Poplar Road), Parkville Victoria, 3052, Australia Centre for Youth Mental Health, University of Melbourne, 35 Poplar Road, Parkville Victoria, 3052, Australia
M. Yücel
Affiliation:
Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health161, Barry Street, Carlton South Victoria, 3053, Australia Brain and Mental Health Laboratory (BMH), School of Psychological Sciences & Monash Biomedical Imaging Facility, Monash University, Clayton, Australia
C.A. Macneil
Affiliation:
Orygen Youth Health-Clinical Program35, Poplar Road Parkville, 3052, Australia
M.K. Hasty
Affiliation:
Orygen Youth Health-Clinical Program35, Poplar Road Parkville, 3052, Australia
B. Murphy
Affiliation:
Department of Psychiatry, Monash University, Clayton, Australia
C. Pantelis
Affiliation:
Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health161, Barry Street, Carlton South Victoria, 3053, Australia Florey Institute for Neuroscience and Mental Health, Kenneth Myer Building, Royal Parade, Parkville, Australia
K.T. Hallam
Affiliation:
Department of Psychology, Victoria University, Melbourne, Australia
L.P. Henry
Affiliation:
Orygen, The National Centre of Excellence in Youth Mental Health, Locked Bag 10 (35, Poplar Road), Parkville Victoria, 3052, Australia
P. Conus
Affiliation:
Treatment and Early Intervention in Psychosis Program (TIPP), département de psychiatrie CHUV, université de Lausanne, clinique de Cery, Prilly, Switzerland
A. Ratheesh
Affiliation:
Orygen, The National Centre of Excellence in Youth Mental Health, Locked Bag 10 (35, Poplar Road), Parkville Victoria, 3052, Australia Centre for Youth Mental Health, University of Melbourne, 35 Poplar Road, Parkville Victoria, 3052, Australia Orygen Youth Health-Clinical Program35, Poplar Road Parkville, 3052, Australia
L. Kader
Affiliation:
Orygen Youth Health-Clinical Program35, Poplar Road Parkville, 3052, Australia
M.T.H. Wong
Affiliation:
School of Psychology and Psychiatry, Faculty of Medicine,Nursing and Health Sciences, Monash University, Clayton, Australia
P.D. McGorry
Affiliation:
Orygen, The National Centre of Excellence in Youth Mental Health, Locked Bag 10 (35, Poplar Road), Parkville Victoria, 3052, Australia Centre for Youth Mental Health, University of Melbourne, 35 Poplar Road, Parkville Victoria, 3052, Australia Orygen Youth Health-Clinical Program35, Poplar Road Parkville, 3052, Australia
M. Berk
Affiliation:
Orygen, The National Centre of Excellence in Youth Mental Health, Locked Bag 10 (35, Poplar Road), Parkville Victoria, 3052, Australia Centre for Youth Mental Health, University of Melbourne, 35 Poplar Road, Parkville Victoria, 3052, Australia Florey Institute for Neuroscience and Mental Health, Kenneth Myer Building, Royal Parade, Parkville, Australia IMPACT Strategic Research Centre, School of Medicine, Deakin University, PO Box 281 Geelong, 3220, Australia Barwon Health and the Geelong Clinic, Swanston Centre, PO Box 281, Geelong Victoria, 3220, Australia
*
*Corresponding author.Orygen, The National Centre of Excellence in Youth Mental Health, Locked Bag 10 (35, Poplar Road), Parkville, 3052 Victoria, Australia. Tel.: +613 9342 2994; fax: +613 9342 2858. E-mail address:rose.daglas@orygen.org.au (R. Daglas).
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Abstract

Background

Cognitive deficits have been reported during the early stages of bipolar disorder; however, the role of medication on such deficits remains unclear. The aim of this study was to compare the effects of lithium and quetiapine monotherapy on cognitive performance in people following first episode mania.

Methods

The design was a single-blind, randomised controlled trial on a cohort of 61 participants following first episode mania. Participants received either lithium or quetiapine monotherapy as maintenance treatment over a 12-month follow-up period. The groups were compared on performance outcomes using an extensive cognitive assessment battery conducted at baseline, month 3 and month 12 follow-up time-points.

Results

There was a significant interaction between group and time in phonemic fluency at the 3-month and 12-month endpoints, reflecting greater improvements in performance in lithium-treated participants relative to quetiapine-treated participants. After controlling for multiple comparisons, there were no other significant interactions between group and time for other measures of cognition.

Conclusion

Although the effects of lithium and quetiapine treatment were similar for most cognitive domains, the findings imply that early initiation of lithium treatment may benefit the trajectory of cognition, specifically verbal fluency in young people with bipolar disorder. Given that cognition is a major symptomatic domain of bipolar disorder and has substantive effects on general functioning, the ability to influence the trajectory of cognitive change is of considerable clinical importance.

Keywords

ManiaBipolar disorderCognitionLithiumQuetiapineEarly intervention
Type
Original article
Information
European Psychiatry , Volume 31 , January 2016 , pp. 20 - 28
Copyright
Copyright © European Psychiatric Association 2015

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