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Lithium Augmentation Therapy in Tricyclic-Resistant Depression

A Controlled Trial Using Lithium in Low and Normal Doses

Published online by Cambridge University Press:  02 January 2018

George Stein  and
Morris Bernadt
George Stein
Affiliation:
Farnborough Hospital, Farnborough Common, Farnborough, Kent BR6 8ND and King's College Hospital
Morris Bernadt
Affiliation:
Department of Psychological Medicine, King's College Hospital, Denmark Hill, London SE5 9RS
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Abstract

Thirty-four patients with tricyclic-resistant depressive illness took part in a nine-week, doubleblind, placebo-controlled trial of lithium augmentation. In addition to the maximum tolerated doses of their tricyclic antidepressant, the experimental group (n = 16) received 250 mg lithium daily for three weeks, followed by 750 mg lithium daily for six weeks, while the controls (n = 18) received placebo for three weeks followed by three weeks each of 250 mg lithium daily and 750 mg lithium daily. There was no significant difference between placebo and 250 mg lithium for weeks 0-3 of the trial. However, there was a significantly greater improvement on the MADRS for weeks 3-6 for those subjects on 750 mg lithium than for those on 250 mg lithium. In addition, using a 50% fall in the HRSD as a criterion of drug responsiveness, 22% responded to placebo, 18% to 250 mg lithium, and 44% to 750mg lithium. Thus, lithium in normal, but not in low, dose has a significant antidepressant effect in TCA-resistant depression. Further controlled studies using lithium in normal dose in trials which have a greater duration of placebo exposure are required to confirm the lithium augmentation effect.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 162 , Issue 5 , May 1993 , pp. 634 - 640
Copyright
Copyright © Royal College of Psychiatrists, 1993 

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