Taking part

Bipolar disorder (BD) is a serious mental illness marked by repeating moods of feeling either very high (which is called mania or hypomania) or feeling sad, low and tired, which is called depression. After one of these episodes has been brought under control, it is important that treatment continues to stop another one happening. This is called maintenance treatment.

Patients say that finding the right maintenance treatment early on can stop years of suffering. The official guidelines state that lithium should be given first as a maintenance treatment. However, doctors often give lithium and medicines called antipsychotics, such as quetiapine, together or by themselves. Both can have side effects which can make them difficult to take for a long time.

We do not know whether taking lithium and quetiapine together over a long time is better than taking them alone for people with BD. We want to find out more about this, so we will carry out a study to understand which maintenance treatment for BD is better, lithium and quetiapine together, lithium alone, or quetiapine alone.

We will find this out by measuring the time to participants becoming ill and having a new high or low mood episode over a two-year period. We will also look at how the treatment effects quality of life, side effects, general impact on health, and coping with everyday tasks. Taking all this information together, we also want to work out which option is better value for money for the NHS.