LITHIUM DISCONTINUATION AND SUBSEQUENT EFFECTIVENESS

Objective: Several reports have raised concern that the discontinuatio n of lithium may result in treatment resistance following recurrence o f affective disorder. This report explores this possibility. Method: T he data derive from a large, naturalistic follow-up of patients with ? major depressive disorder or mania. Twenty-eight of the patients in th e study were free of lithium and experiencing art episode of mania or schizoaffective mania diagnosed according to Research Diagnostic Crite ria when they entered the study, recovered while taking lithium, Inter experienced a recurrence while not taking lithium, and then resumed l ithium treatment. Survival analyses of time to recovery and, subsequen tly, time to recurrence, used continued lithium treatment as an additi onal censoring variable. Results: Patients given lithium recovered no more quickly from their index episode than they did from their first p rospectively observed episode. Moreover, lithium prophylaxis appeared no less effective after the first prospectively observed episode than after the index episode. Conclusions: These findings provide no eviden ce that lithium discontinuation results in treatment resistance when l ithium is resumed.