European Archives of Psychiatry and Clinical Neuroscience

, 247:42

Lithium vs carbamazepine in the maintenance treatment of schizoaffective disorder: a randomised study

  • W. Greil
  • W. Ludwig-Mayerhofer
  • N. Erazo
  • R. R. Engel
  • A. Czernik
  • H. Giedke
  • B. Müller-Oerlinghausen
  • M. Osterheider
  • G. A. E. Rudolf
  • H. Sauer
  • J. Tegeler
  • T. Wetterling
Original Paper

DOI: 10.1007/BF02916252

Cite this article as:
Greil, W., Ludwig-Mayerhofer, W., Erazo, N. et al. Eur Arch Psychiatry Clin Nuerosci (1997) 247: 42. doi:10.1007/BF02916252

Abstract

In a randomised multicentre study, the prophylactic efficacy of lithium and carbamazepine was compared in schizoaffective disorder. A total of 90 ICD-9 schizoaffective patients were included in the maintenance phase (2.5 years). They were also diagnosed according to RDC and DSM-III-R and classified into subgroups. Mean serum levels were 0.58±0.12 mmol/l for lithium and 6.4±1.5 μg/ml for carbamazepine (mean dose 643±179 mg/d). Outcome criteria were hospitalisation, recurrence, concomitant psychotropic medication and adverse effects leading to discontinuation. There were more non-completers under carbamazepine than under lithium (p=0.02). Survival analyses demonstrated no significant differences between lithium and carbamazepine in treatment outcome. Patient’s ratings of side effects (p=0.003) and treatment satisfaction (p=0.02) favoured carbamazepine. Following the RDC criteria, patients of the schizodepressive and non-classifiable type did better under carbamazepine (p=0.055 for recurrence), whereas in the schizomanic patients equipotency of both drugs was found. Applying DSM-III-R, carbamazepine demonstrated a superiority in the patient group with more schizophrenia-like or depressive disorders (p=0.040 for recurrence), but not in patients fulfilling the DSM-III-R criteria of bipolar disorder. Lithium and carbamazepine seem to be equipotent alternatives in the maintenance treatment of broadly defined schizoaffective disorders. However, in subgroups with depressive or schizophrenia-like features and regarding its long-term tolerability carbamazepine seems to be superior.

Key words

Schizoaffective disorderRandomised controlled trialLithiumCarbamazepineTreatment outcome

Copyright information

© Springer-Verlag 1997

Authors and Affiliations

  • W. Greil
    • 1
  • W. Ludwig-Mayerhofer
    • 1
  • N. Erazo
    • 1
  • R. R. Engel
    • 1
  • A. Czernik
    • 2
  • H. Giedke
    • 3
  • B. Müller-Oerlinghausen
    • 4
  • M. Osterheider
    • 5
  • G. A. E. Rudolf
    • 6
  • H. Sauer
    • 7
  • J. Tegeler
    • 8
  • T. Wetterling
    • 9
  1. 1.Psychiatric Hospital of the University of MunichMunichGermany
  2. 2.Psychiatric Hospital of the RWTHAachenGermany
  3. 3.Department of PsychiatryUniversity of TübingenTübingenGermany
  4. 4.Department of PsychiatryFreie Universität BerlinBerlinGermany
  5. 5.Psychiatric Hospital of the University of WürzburgWürzburgGermany
  6. 6.Psychiatric Hospital of the University of MünsterMünsterGermany
  7. 7.Psychiatric Hospital of the University of HeidelbergHeidelbergGermany
  8. 8.Psychiatric Hospital of the University of DüsseldorfDüsseldorfGermany
  9. 9.Psychiatric Hospital of the Medical University of LübeckLübeckGermany