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Am J Psychiatry 1995; 152:1810-1811
Copyright © 1995 by American Psychiatric Association
Nonresponse to reinstituted lithium prophylaxis in previously responsive bipolar patients: prevalence and predictors
M Maj, R Pirozzi and L Magliano
Department of Psychiatry, First Medical School, University of Naples, Italy.
OBJECTIVE: The authors explored the prevalence and predictors of
nonresponse to reinstituted lithium prophylaxis in bipolar patients who had
relapsed after discontinuation of successful lithium treatment. METHOD: The
study was conducted with 54 bipolar patients for whom lithium had been
reintroduced after one or more recurrences following discontinuation of
successful prophylaxis. They were followed up, through bimonthly personal
interviews, for 1 year after recovery from the episode during which lithium
treatment had been resumed, or up to the first recurrence with onset after
lithium reinstitution. RESULTS: During the follow-up period, 44 patients
did not have any affective episodes, whereas 10 had at least one
recurrence. The only significant difference between the two patient groups
was the longer duration of prediscontinuation lithium treatment for the
patients who relapsed. CONCLUSIONS: Nonresponse to reinstituted prophylaxis
should be considered among the possible risks of the interruption of
effective long-term lithium treatment.
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