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Predictors of response to lithium in patients with psychoses

Published Online:https://doi.org/10.1176/ajp.152.10.1511

OBJECTIVE: This study sought to characterize a subset of patients with DSM-III schizophrenia or schizophreniform disorder who respond to lithium. METHOD: Sixty-six psychotic patients were given a systematic therapeutic trial of lithium alone. Differences in demographic characteristics, symptoms, and family history of psychotic disorders between the responders and nonresponders to lithium were explored. RESULTS: Responders and nonresponders did not differ significantly in age, duration of illness, length of current episode, distribution of RDC and DSM-III diagnoses, or number of positive symptoms. However, the responders to lithium (N = 10) exhibited a paucity of negative symptoms and an absence of familial schizophrenic spectrum disorders. CONCLUSIONS: These preliminary results suggest the possibility of pretreatment identification of psychotic patients for whom neuroleptic medication could be avoided by therapeutic intervention with lithium alone.

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