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Published Online:https://doi.org/10.1176/ajp.127.11.1555

The authors conducted a single-blind study to determine whether patients with manic-depressive disease who responded favorably to lithium would show significant change when placebo was substituted. Symptoms recurred in all subjects within six weeks of placebo substitution, and clinical stability returned when lithium treatment was resumed. These findings are discussed in relation to the question of the prophylactic influence of long-term maintenance on lithium.

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