An exploratory study of responses to low-dose lithium in African Americans and Hispanics

Jodi Gonzalez Arnold, Stephanie Salcedo, Terrence A. Ketter, Joseph R. Calabrese, Dustin J. Rabideau, Andrew A. Nierenberg, Melissa Bazan, Andrew C. Leon, Edward S. Friedman, Dan Iosifescu, Louisa G. Sylvia, Michael Ostacher, Michael Thase, Noreen A. Reilly-Harrington, Charles L. Bowden

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Abstract Objectives Few prospective studies examine the impact of ethnicity or race on outcomes with lithium for bipolar disorder. This exploratory study examines differences in lithium response and treatment outcomes in Hispanics, African Americans, and non-Hispanic whites with bipolar disorder in the Lithium Treatment Moderate Dose Use Study (LiTMUS). Methods LiTMUS was a six-site randomized controlled trial of low-dose lithium added to optimized treatment (OPT; personalized, evidence-based pharmacotherapy) vs. OPT alone in outpatients with bipolar disorder. Of 283 participants, 47 African Americans, 39 Hispanics, and 175 non-Hispanic whites were examined. We predicted minority groups would have more negative medication attitudes and higher attrition rates, but better clinical outcomes. Results African Americans in the lithium group improved more on depression and life functioning compared to whites over the 6 month study. African Americans in the OPT only group had marginal improvement on depression symptoms. For Hispanics, satisfaction with life did not significantly improve in the OPT only group, in contrast to whites and African Americans who improved over time on all measures. Attitudes toward medications did not differ across ethnic/racial groups. Conclusions African Americans show some greater improvements with lithium than non-Hispanic whites, and Hispanics showed more consistent improvements in the lithium group. The impact of low-dose lithium should be studied in a larger sample as there may be particular benefit for African Americans and Hispanics. Given that the control group (regardless of ethnicity/race) had significant improvements, optimized treatment may be beneficial for any ethnic group.

Original languageEnglish (US)
Article number7320
Pages (from-to)224-228
Number of pages5
JournalJournal of Affective Disorders
Volume178
DOIs
StatePublished - Jul 1 2015

Fingerprint

Lithium
Hispanic Americans
African Americans
Bipolar Disorder
Ethnic Groups
Depression
Minority Groups
Therapeutics
Outpatients
Randomized Controlled Trials
Prospective Studies
Drug Therapy
Control Groups

Keywords

  • African Americans
  • Bipolar disorder
  • Health disparities
  • Hispanics
  • Lithium
  • Treatment outcome

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology

Cite this

Gonzalez Arnold, J., Salcedo, S., Ketter, T. A., Calabrese, J. R., Rabideau, D. J., Nierenberg, A. A., ... Bowden, C. L. (2015). An exploratory study of responses to low-dose lithium in African Americans and Hispanics. Journal of Affective Disorders, 178, 224-228. [7320]. https://doi.org/10.1016/j.jad.2015.02.035

An exploratory study of responses to low-dose lithium in African Americans and Hispanics. / Gonzalez Arnold, Jodi; Salcedo, Stephanie; Ketter, Terrence A.; Calabrese, Joseph R.; Rabideau, Dustin J.; Nierenberg, Andrew A.; Bazan, Melissa; Leon, Andrew C.; Friedman, Edward S.; Iosifescu, Dan; Sylvia, Louisa G.; Ostacher, Michael; Thase, Michael; Reilly-Harrington, Noreen A.; Bowden, Charles L.

In: Journal of Affective Disorders, Vol. 178, 7320, 01.07.2015, p. 224-228.

Research output: Contribution to journalArticle

Gonzalez Arnold, J, Salcedo, S, Ketter, TA, Calabrese, JR, Rabideau, DJ, Nierenberg, AA, Bazan, M, Leon, AC, Friedman, ES, Iosifescu, D, Sylvia, LG, Ostacher, M, Thase, M, Reilly-Harrington, NA & Bowden, CL 2015, 'An exploratory study of responses to low-dose lithium in African Americans and Hispanics', Journal of Affective Disorders, vol. 178, 7320, pp. 224-228. https://doi.org/10.1016/j.jad.2015.02.035
Gonzalez Arnold J, Salcedo S, Ketter TA, Calabrese JR, Rabideau DJ, Nierenberg AA et al. An exploratory study of responses to low-dose lithium in African Americans and Hispanics. Journal of Affective Disorders. 2015 Jul 1;178:224-228. 7320. https://doi.org/10.1016/j.jad.2015.02.035
Gonzalez Arnold, Jodi ; Salcedo, Stephanie ; Ketter, Terrence A. ; Calabrese, Joseph R. ; Rabideau, Dustin J. ; Nierenberg, Andrew A. ; Bazan, Melissa ; Leon, Andrew C. ; Friedman, Edward S. ; Iosifescu, Dan ; Sylvia, Louisa G. ; Ostacher, Michael ; Thase, Michael ; Reilly-Harrington, Noreen A. ; Bowden, Charles L. / An exploratory study of responses to low-dose lithium in African Americans and Hispanics. In: Journal of Affective Disorders. 2015 ; Vol. 178. pp. 224-228.
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abstract = "Abstract Objectives Few prospective studies examine the impact of ethnicity or race on outcomes with lithium for bipolar disorder. This exploratory study examines differences in lithium response and treatment outcomes in Hispanics, African Americans, and non-Hispanic whites with bipolar disorder in the Lithium Treatment Moderate Dose Use Study (LiTMUS). Methods LiTMUS was a six-site randomized controlled trial of low-dose lithium added to optimized treatment (OPT; personalized, evidence-based pharmacotherapy) vs. OPT alone in outpatients with bipolar disorder. Of 283 participants, 47 African Americans, 39 Hispanics, and 175 non-Hispanic whites were examined. We predicted minority groups would have more negative medication attitudes and higher attrition rates, but better clinical outcomes. Results African Americans in the lithium group improved more on depression and life functioning compared to whites over the 6 month study. African Americans in the OPT only group had marginal improvement on depression symptoms. For Hispanics, satisfaction with life did not significantly improve in the OPT only group, in contrast to whites and African Americans who improved over time on all measures. Attitudes toward medications did not differ across ethnic/racial groups. Conclusions African Americans show some greater improvements with lithium than non-Hispanic whites, and Hispanics showed more consistent improvements in the lithium group. The impact of low-dose lithium should be studied in a larger sample as there may be particular benefit for African Americans and Hispanics. Given that the control group (regardless of ethnicity/race) had significant improvements, optimized treatment may be beneficial for any ethnic group.",
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AU - Calabrese, Joseph R.

AU - Rabideau, Dustin J.

AU - Nierenberg, Andrew A.

AU - Bazan, Melissa

AU - Leon, Andrew C.

AU - Friedman, Edward S.

AU - Iosifescu, Dan

AU - Sylvia, Louisa G.

AU - Ostacher, Michael

AU - Thase, Michael

AU - Reilly-Harrington, Noreen A.

AU - Bowden, Charles L.

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N2 - Abstract Objectives Few prospective studies examine the impact of ethnicity or race on outcomes with lithium for bipolar disorder. This exploratory study examines differences in lithium response and treatment outcomes in Hispanics, African Americans, and non-Hispanic whites with bipolar disorder in the Lithium Treatment Moderate Dose Use Study (LiTMUS). Methods LiTMUS was a six-site randomized controlled trial of low-dose lithium added to optimized treatment (OPT; personalized, evidence-based pharmacotherapy) vs. OPT alone in outpatients with bipolar disorder. Of 283 participants, 47 African Americans, 39 Hispanics, and 175 non-Hispanic whites were examined. We predicted minority groups would have more negative medication attitudes and higher attrition rates, but better clinical outcomes. Results African Americans in the lithium group improved more on depression and life functioning compared to whites over the 6 month study. African Americans in the OPT only group had marginal improvement on depression symptoms. For Hispanics, satisfaction with life did not significantly improve in the OPT only group, in contrast to whites and African Americans who improved over time on all measures. Attitudes toward medications did not differ across ethnic/racial groups. Conclusions African Americans show some greater improvements with lithium than non-Hispanic whites, and Hispanics showed more consistent improvements in the lithium group. The impact of low-dose lithium should be studied in a larger sample as there may be particular benefit for African Americans and Hispanics. Given that the control group (regardless of ethnicity/race) had significant improvements, optimized treatment may be beneficial for any ethnic group.

AB - Abstract Objectives Few prospective studies examine the impact of ethnicity or race on outcomes with lithium for bipolar disorder. This exploratory study examines differences in lithium response and treatment outcomes in Hispanics, African Americans, and non-Hispanic whites with bipolar disorder in the Lithium Treatment Moderate Dose Use Study (LiTMUS). Methods LiTMUS was a six-site randomized controlled trial of low-dose lithium added to optimized treatment (OPT; personalized, evidence-based pharmacotherapy) vs. OPT alone in outpatients with bipolar disorder. Of 283 participants, 47 African Americans, 39 Hispanics, and 175 non-Hispanic whites were examined. We predicted minority groups would have more negative medication attitudes and higher attrition rates, but better clinical outcomes. Results African Americans in the lithium group improved more on depression and life functioning compared to whites over the 6 month study. African Americans in the OPT only group had marginal improvement on depression symptoms. For Hispanics, satisfaction with life did not significantly improve in the OPT only group, in contrast to whites and African Americans who improved over time on all measures. Attitudes toward medications did not differ across ethnic/racial groups. Conclusions African Americans show some greater improvements with lithium than non-Hispanic whites, and Hispanics showed more consistent improvements in the lithium group. The impact of low-dose lithium should be studied in a larger sample as there may be particular benefit for African Americans and Hispanics. Given that the control group (regardless of ethnicity/race) had significant improvements, optimized treatment may be beneficial for any ethnic group.

KW - African Americans

KW - Bipolar disorder

KW - Health disparities

KW - Hispanics

KW - Lithium

KW - Treatment outcome

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