Comparison of the efficacy and safety of quetiapine and lithium for bipolar depression: A systematic review and meta‐analysis of randomized controlled trials

Abstract

Aim: Pharmacological treatments recommended for bipolar depression are inconsistent across guidelines. We compared the efficacy and safety of antipsychotics and mood stabilizers for bipolar depression. Methods:A systemic review and meta-analysis of randomized controlled trials comparing antipsychotics and mood stabilizers for bipolar depression was conducted based on a literature search of major electronic databases.Results: Three studies comparing quetiapine with lithium were identified and analyzed; no other antipsychotic-mood stabilizer combinations were found. The metaanalysis revealed no significant differences between quetiapine and lithium for the following outcomes: (1) remission from depressive episodes (risk ratio [RR]: 1.80, 95% CI: 0.51-6.40, P = 0.36), (2) changes in depressive symptom (standardized mean difference: −0.22, 95% CI: −0.52-0.08, P = 0.15), (3) changes in social function (standardized mean difference: −0.00, 95% CI: −0.19-0.18, P = 0.98), (4) suicide-related events (odds