{"id":"e9c87670-4970-5677-955f-b716d36764a4","stable_key":"b7798a90-72a3-5454-a321-c4be88bf0cc4:lithium-bipolar-relapse","predicate":"reduces_relative_risk_of","statement":"Lithium monotherapy had fewer new mood-episode interventions than valproate in BALANCE; adding valproate was not clearly superior to lithium alone.","claim_class":"observational","status":"source_derived_draft","evidence_grade":"ungraded","direction":"context_dependent","is_public":true,"mechanism_event_id":"dce1915e-706f-5b7a-bfd6-14fda6b24878","mechanism_event_label":"Clinical mood efficacy has its own evidence, separate from dementia hypotheses.","subject":{"id":"bb5db13c-d287-5847-93b2-98ab0d023797","slug":"lithium-carbonate","display_name":"Lithium carbonate","entity_type_key":"small_molecule"},"object":{"id":"c9d87098-c2f0-5bc2-a7d9-903beecab799","slug":"human-balance-mood-intervention","display_name":"New mood-episode intervention in the BALANCE trial","entity_type_key":"cellular_process"},"evidence_count":1,"mechanism_event":{"id":"dce1915e-706f-5b7a-bfd6-14fda6b24878","stable_key":"b7798a90-72a3-5454-a321-c4be88bf0cc4:lithium-bipolar-relapse-event","event_type":"observed_relationship","label":"Clinical mood efficacy has its own evidence, separate from dementia hypotheses.","description":"Lithium monotherapy had fewer new mood-episode interventions than valproate in BALANCE; adding valproate was not clearly superior to lithium alone.","status":"provisional","compartment":null,"participants":[{"entity":{"id":"bb5db13c-d287-5847-93b2-98ab0d023797","slug":"lithium-carbonate","display_name":"Lithium carbonate","entity_type_key":"small_molecule"},"role":"subject","stoichiometry":null,"state_label":"","sequence_order":0,"notes":""},{"entity":{"id":"c9d87098-c2f0-5bc2-a7d9-903beecab799","slug":"human-balance-mood-intervention","display_name":"New mood-episode intervention in the BALANCE trial","entity_type_key":"cellular_process"},"role":"target","stoichiometry":null,"state_label":"","sequence_order":1,"notes":""},{"entity":{"id":"8e2e3902-5e26-52e3-9c85-1d7c0ace1637","slug":"lithium","display_name":"Lithium","entity_type_key":"nutrient_element"},"role":"context_participant","stoichiometry":null,"state_label":"","sequence_order":2,"notes":""},{"entity":{"id":"13b4b09c-4581-58f6-9792-9a78125963e8","slug":"lithium-ion","display_name":"Lithium ion (Li+)","entity_type_key":"ion"},"role":"context_participant","stoichiometry":null,"state_label":"","sequence_order":3,"notes":""}]},"contexts":[{"dimension":"evidence_access","value_text":"Primary abstract","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"experimental_model","value_text":"330 randomized bipolar-I patients; open-label treatment with masked event review; up to two years.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"limitations","value_text":"Combination run-in and open-label design matter; the trial does not identify a single molecular mediator.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"nutrient_topic","value_text":"Lithium collection; molecular form, preparation, species, exposure and manipulation remain explicit.","comparator":null,"unit":null,"notes":"","entity":{"slug":"lithium","display_name":"Lithium","entity_type_key":"nutrient_element"}},{"dimension":"plain_language","value_text":"Clinical mood efficacy has its own evidence, separate from dementia hypotheses.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"primary_references","value_text":"Lithium plus valproate combination therapy versus monotherapy for relapse prevention in bipolar I disorder (BALANCE): a randomised open-label trial. · 2010 · https://pubmed.ncbi.nlm.nih.gov/20092882/ · DOI 10.1016/S0140-6736(09)61828-6","comparator":null,"unit":null,"notes":"","entity":null}],"evidence":[{"id":"850aabe5-ac43-599b-a120-31455d522e13","evidence_kind":"source_excerpt","locator":"Lines 560-566","start_line":560,"end_line":566,"excerpt":"## lithium-bipolar-relapse\nClinical mood efficacy has its own evidence, separate from dementia hypotheses.\nLithium monotherapy had fewer new mood-episode interventions than valproate in BALANCE; adding valproate was not clearly superior to lithium alone.\nModel: 330 randomized bipolar-I patients; open-label treatment with masked event review; up to two years.\nLimitations: Combination run-in and open-label design matter; the trial does not identify a single molecular mediator.\nEvidence access: Primary abstract\nLithium plus valproate combination therapy versus monotherapy for relapse prevention in bipolar I disorder (BALANCE): a randomised open-label trial. · 2010 · https://pubmed.ncbi.nlm.nih.gov/20092882/ · DOI 10.1016/S0140-6736(09)61828-6","model_system":"330 randomized bipolar-I patients; open-label treatment with masked event review; up to two years.","directness":"reported_statement","verification_status":"source_derived_draft","notes":"Original curation paraphrase; evidence access and experimental limitations specified.","relationship":"supports","weight":1.0,"link_notes":"","source":{"id":"b2dd2f3c-5c4c-5a12-9a0d-91b521ffcf98","stable_key":"import-b7798a90-72a3-5454-a321-c4be88bf0cc4","title":"Lithium: metal-sensitive enzymes, transport and cross-nutrient mechanisms (2026-09-19)","document_type":"imported_text","citation_label":"AI-assisted research curation; primary references, access levels and experimental limitations individually identified. Not publisher full text.","file_path":"","sha256":"dc67e965ba78458cf2d88d000d687641d9104354115ab16529a3a64941bd777d","revision_id":"4af127bf-9ccc-516b-9481-fafd453c2c35","review_status":"unverified_draft","notes":""}}],"relations":[],"conflicts":[],"corrections":[],"research":null}