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A Comparison in Recurrent Affective Illness

Report of the Veterans Administration and National Institute of Mental Health Collaborative Study Group; Robert F. Prien, PhD; C. James Klett, PhD; Eugene M. Caffey, Jr., MD

Arch Gen Psychiatry. 1973;29(3):420-425.

Abstract
Patients with recurrent affective illness (N-122) were randomly assigned to lithium carbonate, imipramine, or placebo therapy for two years following discharge from hospitalization for acute depression. Patients were classified as bipolar or unipolar based on the presence or absence of a history of mania. With bipolar patients lithium carbonate was significantly more effective than imipramine or placebo in preventing affective episodes (ie, manic or depressive attacks severe enough to require hospitalization or use of nonstudy drugs). There was a relatively high incidence of manic episodes on imipramine.

Unipolar patients responded equally well to lithium carbonate or imipramine. Both treatments were significantly more effective than placebo. The difference between treatments was due primarily to depressive episodes; manic episodes occurred infrequently and were evenly distributed across treatment groups. There was no significant difference between lithium carbonate and imipramine among unipolar patients.

Author Affiliations
Washington, DC

From the Central Neuropsychiatric Research Laboratory, Veterans Administration Hospital (Drs. Prien and Klett), Perry Point, Md, and the Mental Health and Behavioral Sciences Service, Department of Medicine and Surgery, Veterans Administration (Dr. Caffey), Washington, DC.

Footnotes
Accepted for publication March 6, 1973.

Reprint requests to Central Neuropsychiatric Research Laboratory, Veterans Administration Hospital, Perry Point, MD 21902 (Dr. Prien).

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