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Many patients with bipolar disorder are treated with anticonvulsants, atypical antipsychotics, or their combination, but remain symptomatic. This multisite comparative effectiveness study of lithium enrolled 283 patients with bipolar I or II disorder who were not taking lithium and were sufficiently symptomatic to warrant change in treatment (>85% at least moderately ill; the majority depressed).
Participants were randomized to lithium plus optimized personalized treatment (OPT; a manualized evidence-based treatment developed in conjunction with the Texas Medication Algorithm Project) or OPT alone and were followed for 6 months. OPT allowed use of various regimens of anticonvulsants, atypical antipsychotics, or both. The groups were demograp…