Summary table of ADVANTAGES and DISADVANTAGES of medication options

= Possible disadvantage that is serious and may involve stopping medication.
= Possible disadvantage that can be managed/tolerated.
= Possible advantage.
LITHIUM LAMOTRIGINE QUETIAPINE
Effectiveness Effective against both hypomania and depression relapse. More effective against depression relapse. Uncertain how effective against hypomanic relapse. Effective against both hypomania and depression relapse.
Tolerance of side effects 84 in 100 people 91 in 100 people 92-94 in 100 people
Cognitive ‘dulling’ (i.e. difficulties thinking) 20-25 in 100 people No link 5-16 in 100 people
Sleepiness/drowsiness 13 in 100 people No link 6-19 in 100 people
Weight gain (> 7% of body weight) 10-12 in 100 people No link 6-10 in 100 people
Toxicity/safety

Under-active thyroid = 13-14 in 100 people

Chronic kidney disease = 1-2 in 100 people

Complete kidney failure = ~ 5 in 1000 people

Non-serious rash = 8-9 in 100 people.

Serious rash = 1 in 10,000 to 1 in 1000 people.
Metabolism changes = 7-15 in 100 people
Long-term monitoring Required

Generally not required.

Remain alert to rash.

Required
Time to take effect

Longer time to take full effect than some other medications.

Longer time to take full effect than some other medications.

Shorter time to take full effect than some other medications.

Cost/affordability

PBS subsidised. Costs less than some other medications.

Not PBS subsidised for BPII. Costs more than some other medications.

Not PBS subsidised for BPII unless used as an add-on to other medications. Costs more than some other medications.