Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-28T18:15:19.539Z Has data issue: false hasContentIssue false
  • English
  • Français

Prediction of Rapid Relapse Following Lithium Discontinuation

Published online by Cambridge University Press:  13 June 2014

A.J. Mander
A.J. Mander*
Affiliation:
University Department of Psychiatry, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF
Get access Rights & Permissions [Opens in a new window]

Abstract

All twenty-nine bipolar 1 patents who satisfied DSM-111 criteria following their first hospitalisation for mania and subsequently discontinued their prophylactic lithium after a mean of 29 ± 21 months were studied. Patients were classified into poor prognosis (relapsed within 3 months of discontinuation, n = 8) and good prognosis groups (relapsed after 3 months or did not relapse, n = 21). Poor prognosis patients were more likely to have been prescribed additional psychotropic medication in the previous year (P = 0.026) and had higher serum lithium levels immediately prior to lithium discontinuation (P = 0.0043). Recent additional psychotropic medication may indicate that the patient is at an increased risk of early relapse if lithium prophylaxis is being stopped for any reason. The increased risk for those patients with higher lithium levels suggest that gradual phased reductions would be prudent.

Keywords

LithiumSubstance Withdrawal Syndrome
Type
Original Article
Information
Irish Journal of Psychological Medicine , Volume 6 , Issue 1 , March 1989 , pp. 23 - 25
Copyright
Copyright © Cambridge University Press 1989

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Mander, AJ: Is there a lithium withdrawal syndrome? British Journal of Psychiatry 1986; 149: 498–501CrossRefGoogle Scholar
2.Mander, AJ, Loudon, B: Rapid recurrence of mania following abrupt discontinuation of lithium prophylaxis. Lancet 1988; ii: 15–17CrossRefGoogle Scholar
3.Margo, A, McMahon, P: Lithium withdrawal triggers psychosis. British Journal of Psychiatry 1982; 141: 407–410CrossRefGoogle ScholarPubMed
4.Blackburn, M, Loudon, JB, Ashworth, CM: A new scale for measuring mania. Psychological Medicine 1977; 7: 452–458CrossRefGoogle ScholarPubMed
5.Small, JG, Small, IF, Moore, DF: Experimental withdrawal of lithium in recovered manic depressive patients: A report of 5 cases. Am J of Psychiatry 1971; 127: 1555–1558CrossRefGoogle Scholar
6.Lapierre, YD, Gagnon, A, Kokkinidis, L: Rapid recurrence of mania following lithium withdrawal. Biological Psychiatry 1980; 1: 859–864Google Scholar
7.Vinar, O: Mania as a phenomenon of lithium withdrawal. Acta Nerv Supra (Praha) 1981; 23, 282–283Google ScholarPubMed
8.Christodolou, GN, Lykouras, EP: Abrupt lithium discontinuation in manic depressive patients. Acta Psychiatrica Scandinavica 1982; 65: 310–314CrossRefGoogle Scholar
9.King, JR, Hullin, RP: Withdrawal symptoms from lithium. Four case reports and a questionnaire study. Br J Psychiatry 1983; 143: 30–35CrossRefGoogle Scholar
10.Wilkinson, DG: Stopping lithium prophylaxis? Br Med J 1979; 278: 235–236CrossRefGoogle Scholar
11.Yuce, M: Difficulty in stopping lithium prophylaxis? Br Med J 1979; 278: 1020CrossRefGoogle Scholar
12.Cordess, C: Mania after lithium withdrawal? Br J Psychiatry 1982; 41: 431.CrossRefGoogle Scholar
13.Greil, W, Schmidt, S: Lithium withdrawal reactions. In Birch, NJ (Ed) Lithium: Inorganic Pharmacology and Psychiatric Use. Oxford: IRL Press 1988; 149–153. Presented at the 2nd British Lithium Congress, September 6-9, 1987, Wolverhampton UKGoogle Scholar
14.Goodnick, PJ, Fieve, RR, Schleggel, A, Baxter, N: Predictors of interepisode symptoms and relapse in affective disorder patients treated with lithium carbonate. Am J Psychiatry 1987; 144: 367–369Google ScholarPubMed
15.Berggren, U: The effect of chronic lithium administration and withdrawal on locomotor activity and asomorphine-induced locomotor stimulation in rats. Journal of Neural Transmission 1988; 71: 65–72CrossRefGoogle ScholarPubMed
16.Molnar, G, Pristach, C, Feeney, MGet al: A pilot study of managed lithium discontinuation. Psychopharmacology Bulletin 1988; 24: 217–219Google ScholarPubMed