The prophylactic efficacy of lithium -
transient or persistent?
by
Kleindienst N, Greil W, Ruger B, Moller HJ
Psychiatric Hospital of the University of Munich, Germany.
niko@psy.med.uni-muenchen.de
Eur Arch Psychiatry Clin Neurosci 1999; 249(3):144-9
ABSTRACT
It has been reported recently that the prophylactic efficacy of lithium is a transient phenomenon in many patients. Other studies suggest sustained efficacy
against affective recurrences for many years. As this issue is of major
therapeutic relevance, published literature considering changes in lithium
efficacy over time has been reviewed. The present review includes a critical
evaluation of the data and the methodology which yielded these controversial
results. Considering the published data discussed in this review, the balance of
evidence does not indicate a general loss of lithium efficacy in the prophylaxis
of major affective disorders. A supposed persistence of the prophylactic effects
in general does not, however, exclude the reappearance of affective recurrences
after years of successful treatment in individual cases. Possible reasons for
this phenomenon are discussed.
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