A PROSPECTIVE-STUDY OF LITHIUM CONTINUATION THERAPY IN DEPRESSED-PATIENTS WHO HAVE RESPONDED TO ELECTROCONVULSIVE-THERAPY

Twenty-eight of 34 patients with major depression who completed a cour se of electroconvulsive therapy (ECT) and were classified as responder s were administered lithium carbonate (Li) continuation therapy in the context of an open, prospective study. Twenty-four patients were foll owed for 6 months or until relapse; four patients dropped out of follo w-up while still in omission. The probability of completing 6 months w ithout relapse (by survival analysis, including the patients who dropp ed out as censored observations) was 65%. The eight patients who relap sed into depression all did so within 13 weeks. They were characterize d by a shorter duration of their index depressive episode, a greater l ikelihood of having suffered an additional depressive episode in the p receding 12 months, and failure of an adequate trial of antidepressant medication before the ECT course. Novel pharmacological strategies ma y be needed in the post-ECT continuation therapy of patients who have a prior history of relapse and are demonstrably resistant to antidepre ssant medication.