JW01.02 - Lessons from the long term bipolar study, balance

Abstract

Objectives:

To explore the times of onset of response and remission associated with combination therapy in patients with bipolar I disorder.

Methods:

Patients who are suitable for long term treatment are initially recruited and treated with the combination of lithium and valproate (as ^®Depakote). For a four to eight week run-in period these drugs are given together to assess the tolerability of this combination. At the end of that time patients are randomised to either continue on the combination itself, or lithium alone, or depakote alone

Results:

The central problems are patient recruitment and clinician capacity. An update on trial procedures and progress will be presented. The results will be analysed after trial completion later this year

Conclusions:

The long term treatment of bipolar disorder is frequently based on polypharmacy. While this approach seems logical, it is not supported by much empirical evidence since industry has hitherto had little interest in studying other than monotherapy. BALANCE has the virtue of being enriched for adherence and tolerability. Whether outcomes are better in combination treatment is a finding that will be eagerly awaited.