THE COMBAT OF NONCOMPLIANCE DURING PROPHYLACTIC LITHIUM TREATMENT

Non-compliance is the most frequent cause of recurrence during prophyl actic lithium treatment and is associated with poor response and high levels of suicidality. Non-compliance is a complex phenomenon and may have a number of causes. When manic-depressive patients fare badly und er the conditions of so-called 'naturalistic' trials, this usually ind icates that such conditions are inadequate for long-term maintenance t reatment. Prophylactic lithium treatment must be accompanied by measur es to sustain compliance and counteract drop-out, and these measures b uild on three cornerstones, namely information, support and supervisio n.