Recent clinical studies have reported rapid improvement following
administration of lithium to depressed patients who are unresponsive to
tricyclic antidepressants. The clinical value of lithium augmentation would
be greatest in subtypes of depression refractory to tricyclic treatment,
such as delusional depression. The authors describe the results of a
preliminary study of lithium augmentation in six patients with delusional
depression who were unresponsive to combined neuroleptic-tricyclic
treatment. Of the six, three had a dramatic response, two had a more
gradual response, and one was unresponsive. The authors discuss alternative
mechanisms of lithium action in these patients.
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