Factors Associated with Poor Response to Lithium Carbonate: A Clinical Study
MICHAEL S. ARONOFF M.D.1, and
RICHARD S. EPSTEIN M.D.2
1 Resident in psychiatry, New York State Psychiatric Institute, Columbia-Presbyterian Medical Center, 722 West 168th St., New York, N. Y. 10032
2 Private practice in Bethesda, Md.
Eighteen patients with intermittent manic illness were treated with lithium on a regular basis for an average of two years. An attempt was made to characterize factors related to suboptimal treatment response. A "crisis" state in reaction to a stressful event was observed in suboptimal responders at the time of lithium failure, and a concurrent rise in urinary 17-hydroxycorticosteroid excretion was noted. Possible relationships among lithium ion, metabolic factors, and altered clinical state are discussed.
