European Archives of Psychiatry and Clinical Neuroscience

, 247:42

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

Authors

    • Psychiatric Hospital of the University of Munich
  • W. Ludwig-Mayerhofer
    • Psychiatric Hospital of the University of Munich
  • N. Erazo
    • Psychiatric Hospital of the University of Munich
  • R. R. Engel
    • Psychiatric Hospital of the University of Munich
  • A. Czernik
    • Psychiatric Hospital of the RWTH
  • H. Giedke
    • Department of PsychiatryUniversity of Tübingen
  • B. Müller-Oerlinghausen
    • Department of PsychiatryFreie Universität Berlin
  • M. Osterheider
    • Psychiatric Hospital of the University of Würzburg
  • G. A. E. Rudolf
    • Psychiatric Hospital of the University of Münster
  • H. Sauer
    • Psychiatric Hospital of the University of Heidelberg
  • J. Tegeler
    • Psychiatric Hospital of the University of Düsseldorf
  • T. Wetterling
    • Psychiatric Hospital of the Medical University of Lübeck
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