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Correlation between white blood cell count and mood-stabilising treatment response in two bipolar disorder trials

  • Ole Köhler-Forsberg (a1) (a2), Louisa G. Sylvia (a3) (a4), Charles L. Bowden (a5), Joseph R. Calabrese (a6), Michael E. Thase (a7), Richard C. Shelton (a8), Melvin McInnis (a9), Mauricio Tohen (a10), James H. Kocsis (a11), Terence A. Ketter (a12), Edward S. Friedman (a13), Thilo Deckersbach (a3) (a4), Michael J. Ostacher (a3), Dan V. Iosifescu (a3), Susan McElroy (a14) and Andrew A. Nierenberg (a3) (a4)...



Immune system markers may predict affective disorder treatment response, but whether an overall immune system marker predicts bipolar disorder treatment effect is unclear.


Bipolar CHOICE (N = 482) and LiTMUS (N = 283) were similar comparative effectiveness trials treating patients with bipolar disorder for 24 weeks with four different treatment arms (standard-dose lithium, quetiapine, moderate-dose lithium plus optimised personalised treatment (OPT) and OPT without lithium). We performed secondary mixed effects linear regression analyses adjusted for age, gender, smoking and body mass index to investigate relationships between pre-treatment white blood cell (WBC) levels and clinical global impression scale (CGI) response.


Compared to participants with WBC counts of 4.5–10 × 109/l, participants with WBC < 4.5 or WBC ≥ 10 showed similar improvement within each specific treatment arm and in gender-stratified analyses.


An overall immune system marker did not predict differential treatment response to four different treatment approaches for bipolar disorder all lasting 24 weeks.


Corresponding author

Author for correspondence: Ole Köhler-Forsberg, Email:


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