NONRESPONSE TO REINSTITUTED LITHIUM PROPHYLAXIS IN PREVIOUSLY RESPONSIVE BIPOLAR PATIENTS - PREVALENCE AND PREDICTORS

Objective: The authors explored the prevalence and predictors of nonre sponse to reinstituted lithium prophylaxis in bipolar patients who had relapsed after discontinuation of successful lithium treatment. Metho d: The study was conducted with 54 bipolar patients for whom lithium h ad been reintroduced after one or more recurrences following discontin uation of successful prophylaxis. They were followed up, through bimon thly personal interviews, for 1 year after recovery from the episode d uring which lithium treatment had been resumed, or up to the first rec urrence with onset after lithium reinstitution. Results: During the fo llow-up period, 44 patients did not have any affective episodes, where as 10 had at least one recurrence. The only significant difference bet ween she two patient groups was the longer duration of prediscontinuat ion lithium treatment for the patients who relapsed. Conclusions: Nonr esponse to reinstituted prophylaxis should be considered among the pos sible risks of the interruption of effective long-term lithium treatme nt.