Efficacy, safety and tolerability of combined administration of lithium and selective serotonin reuptake inhibitors: a review of the current evidence

Several case reports have engendered concern about the safety of coadminist ering lithium and selective serotonin reuptake inhibitor (SSRI) antidepress ants and there are theoretical reasons to suppose that lithium and serotone rgic antidepressants may be associated with dangerous interactions. Systema tic reports regarding combination therapy with lithium and SSRI antidepress ants were assimilated for the purpose of this review. Although there are ma ny publications, few are directly informative as to safety and tolerability . A total of 503 patients are considered in systematic reports and, among t hese, no serious or life-threatening adverse events can be identified. Such data as there are demonstrate little potential for toxic interactions betw een lithium and SSRls, although new, non-serious, adverse events do frequen tly arise. The evidence for the efficacy of addition of lithium to SSRIs in treatment refractory depression is only provisional. Int Clin Psychopharma col 15:197-206 (C) 2000 Lippincott Williams & Wilkins.