THE CHALLENGE OF PREDICTING RESPONSE TO STABILIZING LITHIUM TREATMENT- THE IMPORTANCE OF PATIENT SELECTION

Lithium treatment, an approach with well documented efficacy, has rece ntly been losing its treatment value. Lithium continues working, howev er, for those patients for whom it was proven efficacious; that is, mo st patients with primary episodic affective disorders. Such responders to lithium prophylaxis can be reliably identified beforehand by a com prehensive clinical assessment. The explanation for the paradox of lit hium's lost efficacy lies mostly in the educational bias against a com prehensive patient assessment, and in the shift in diagnostic fashion favouring affective disorders and the treatment methods associated wit h them in the clinicians' minds.