Despite cognition being normal or even superior tocontrols prior to a first episode of mania, there is a decline in cognitivecapacity that is arguably steepest in the interval after a first episode ofmania. What is unclear, is the extent to which this can be prevented and whichagents might be most useful for doing so.

This study reports the outcomes of a single-blind, randomised control trial of maintenance therapy with lithium compared toquetiapine after a first episode of mania. Cognition and structural imagingwere the primary endpoints.

This study examined a number of paper and pencil tests ofneurocognition as well as a computerised battery including Cogstate andPresentation. Tests used include the Wechsler Test of Adult Reading, the WechslerAbbreviated Scale of Intelligence, Digit Span and Digit Symbol sub-tests of the Wechsler Adult Intelligence Scale – III, Trail Making Test, Rey Auditory VerbalLearning Test, Controlled Oral Word Association Task, Attention Network Test, Go-Nogoand Stroop Tasks. Results of this study will be presented.

Given that cognition is a major symptomatic domain ofbipolar disorder and has substantive effects on quality of life, functioningand symptomatic outcomes, the ability to influence the trajectory of cognitivechange is of considerable clinical importance.