Am J Psychiatry 1997; 154:548-550
Copyright © 1997 by American Psychiatric Association
Effectiveness of restarting lithium treatment after its discontinuation in bipolar I and bipolar II disorders
L Tondo, RJ Baldessarini, G Floris and N Rudas
International Consortium for Bipolar Disorder Research, Boston, MA, USA.
OBJECTIVE: This study tested the hypothesis that resumption of lithium
treatment of bipolar disorders may be less effective after maintenance
treatment has been discontinued. METHOD: Eighty-six patients with type I or
II bipolar disorder, not selected according to response to treatment, were
followed prospectively during two periods of lithium maintenance treatment
averaging 4.6 and 4.4 years. Morbidity (illness episodes per year,
hospitalizations per year, percentage of time ill) was assessed, and use of
adjunctive medication was rated. RESULTS: Morbidity was similar in the
first and second treatment periods (mean number of episodes = 0.83 and 0.94
per year, respectively; mean percentage of time ill = 18.0% and 24.2%),
with no differences in numbers of manic and depressive episodes or
differences by gender, diagnostic type, length of first treatment, interval
between treatments, or discontinuation rate. There was 12.8% more use of
adjunctive medication in the second period. CONCLUSIONS: The efficacy of
lithium did not differ significantly between the first and second treatment
periods.
