Comparison 3. Lithium vs lamotrigine.

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Efficacy ‐ response (continuous): change in BPRS from baseline to end of trial	3		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
1.1 Efficacy ‐ Change in BPRS from baseline to end of trial	3	301	Mean Difference (IV, Fixed, 95% CI)	‐1.82 [‐3.78, 0.14]
2 Efficacy ‐ response (continuous): MRS (16 item) change from baseline to end of trial	2		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
2.1 MRS 11 item from SAD‐C	2	271	Mean Difference (IV, Fixed, 95% CI)	‐2.74 [‐5.84, 0.36]
2.2 MRS Manic Subscale	2	271	Mean Difference (IV, Fixed, 95% CI)	‐1.38 [‐3.02, 0.26]
2.3 MRS 16 item from SAD‐C	2	271	Mean Difference (IV, Fixed, 95% CI)	‐3.74 [‐7.55, 0.08]
3 Efficacy ‐ response (continuous): CGI severity change from baseline to end of trial	3	304	Mean Difference (IV, Random, 95% CI)	‐0.35 [‐1.24, 0.53]
4 Efficacy ‐ response (continuous): change in GAS from baseline to end of trial	2	270	Mean Difference (IV, Fixed, 95% CI)	4.36 [‐0.65, 9.37]
5 Acceptability	3		Odds Ratio (M‐H, Fixed, 95% CI)	Subtotals only
5.1 All‐cause dropouts	3	303	Odds Ratio (M‐H, Fixed, 95% CI)	0.80 [0.50, 1.29]
5.2 Dropouts due to adverse events	2	273	Odds Ratio (M‐H, Fixed, 95% CI)	0.93 [0.42, 2.06]
5.3 Dropouts due to lack of efficacy	2	273	Odds Ratio (M‐H, Fixed, 95% CI)	1.06 [0.48, 2.32]
6 Efficacy ‐ response (continuous): change in Hamilton depression scale (HAMD 31) from baseline to end of trial	2	271	Mean Difference (IV, Fixed, 95% CI)	‐1.74 [‐3.72, 0.24]
7 Efficacy ‐ response (categorical): ≥ 50% reduction in BPRS from baseline to end of trial	1	30	Odds Ratio (M‐H, Fixed, 95% CI)	0.42 [0.09, 1.92]
8 Efficacy ‐ response(categorical): ≥ 50% reduction in MRS from baseline to end of trial	1	30	Odds Ratio (M‐H, Fixed, 95% CI)	1.31 [0.31, 5.58]
9 Efficacy ‐ response (categorical): CGI scores of 1 or 2 at the end of the trial	1	30	Odds Ratio (M‐H, Fixed, 95% CI)	0.42 [0.09, 1.92]
10 Adverse event: vomiting	2	272	Odds Ratio (M‐H, Fixed, 95% CI)	1.77 [0.75, 4.18]
11 Adverse event: all mania	2	272	Odds Ratio (M‐H, Fixed, 95% CI)	0.63 [0.16, 2.46]
12 Adverse event: diarrhoea	2	272	Odds Ratio (M‐H, Fixed, 95% CI)	3.83 [0.92, 15.92]
13 Adverse event: headache	2	272	Odds Ratio (M‐H, Fixed, 95% CI)	0.96 [0.45, 2.02]
14 Adverse event: tremor	2	272	Odds Ratio (M‐H, Fixed, 95% CI)	1.28 [0.48, 3.41]
15 Adverse event: rash	2	272	Odds Ratio (M‐H, Fixed, 95% CI)	0.58 [0.17, 1.97]
16 Adverse event: somnolence	2	272	Odds Ratio (M‐H, Fixed, 95% CI)	1.14 [0.34, 3.85]
17 Adverse event: any side effects	2	272	Odds Ratio (M‐H, Random, 95% CI)	0.89 [0.47, 1.70]
18 Adverse event: any serious event	1	152	Odds Ratio (M‐H, Fixed, 95% CI)	0.95 [0.26, 3.41]
19 Adverse event: constipation	2	272	Odds Ratio (M‐H, Fixed, 95% CI)	0.78 [0.18, 3.40]
20 Adverse event: accidental injury	2	272	Odds Ratio (M‐H, Fixed, 95% CI)	1.32 [0.43, 4.08]
21 Adverse event: pain	2	272	Odds Ratio (M‐H, Fixed, 95% CI)	0.34 [0.07, 1.65]
22 Use of concomitant psychotropic medication	1	151	Odds Ratio (M‐H, Fixed, 95% CI)	0.25 [0.07, 0.95]
23 Mean total dose of lorazepam (g)	1	30	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]