New trial should clarify lithium use in bipolar disorder

doi:10.1136/bmj.325.7361.441

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John Geddes, senior clinical research fellow (john.geddes@psych.ox.ac.uk),
Guy Goodwin, professor of psychiatry,
Jennifer Rendell, trial manager,
Jane Hainsworth, research assistant,
Emma Van der Gucht, research assistant,
Heather Young, BALANCE trial programmer
On behalf of the BALANCE investigators: Ian Anderson (University of Manchester); Jonathan Cavanagh (University of Glasgow); John Cookson (City and East London Mental Health NHS Trust, Royal London Hospital); Nicol Ferrier and Allan Young (University of Newcastle upon Tyne); Sophia Frangou and Jan Scott (Institute of Psychiatry, London); Peter Jones (Addenbrooke's Hospital, Cambridge); Chris Kelly (Queen's University Belfast); Glyn Lewis (University of Bristol); Keith Lloyd (University of Exeter); Richard Morriss and Christine Healey (University of Liverpool); Malcolm Peet (Rotherham Priority Health NHS Trust, Doncaster Gate Hospital); Ian Reid (University of Dundee); Peter Tyrer (Imperial College School of Medicine, London); and Ed Juszczak and Douglas G Altman (Institute of Health Sciences, Oxford).

Department of Psychiatry, University of Oxford, Oxford OX3 7JX

EDITOR—We agree with Dinan's statement in his editorial that there is considerable evidence that lithium is an effective maintenance treatment in bipolar disorder.1 Our recent Cochrane review found that lithium reduced the relative risk of relapse in bipolar disorder by 42% (95% confidence interval 30% to 52%).2 We …