Discontinuation of lithium augmentation in an elderly cohort

Objectives To observe the effects of gradual discontinuation of lithium aug mentation therapy in a group of patients over the age of 65 years and to me asure the rate of relapse and to identify any factors which would predict r elapse. Methods This was a naturalistic study involving 21 patients who were on lit hium augmentation and whose lithium was discontinued for a variety of clini cal reasons. In most cases lithium was tapered and discontinued over a peri od of 2-12 weeks. Demographic and other variables were collected at baselin e and compared between those who remained well and those that subsequently relapsed. Results Eleven patients (52.4%) relapsed following discontinuation of lithi um augmentation. Those who relapsed had been on lithium for significantly l onger than those who remained well off lithium (p = 0.007). There was a tre nd towards more hospital admissions in the relapse group (p = 0.062). Conclusions When lithium augmentation therapy is discontinued in elderly de pressives over half of these patients relapse. A longer duration of predisc ontinuation lithium treatment and more hospital admissions appear to be ass ociated with increased risk of relapse. Copyright (C) 2001 John Wiley & Son s, Ltd.