To our knowledge, this is one of the first studies
comparing the rehospitalization rates for lithium or
valproate given in combination with an atypical antipsychotic
to bipolar I patients with first-episode
mania. We found that the time before rehospitalization
for any mood episode was significantly longer in
patients receiving valproate plus an atypical antipsychotic
than in those receiving lithium plus an atypical
antipsychotic. A trend toward a significant difference
between the groups was also seen with respect to rates
of rehospitalization due to manic or mixed episodes.
Additionally, we found that patients with bipolar I
disorder who were hospitalized due to a first manic
episode and who received valproate plus an atypical
antipsychotic had lower 1-year rehospitalization rates
for any kind of mood episode than did those who
received lithium plus an atypical antipsychotic, but
the difference did not reach a statistically significant
level.