J Cavanagh1, R Smyth, G M Goodwin. 1. University of Glasgow Department of Psychological Medicine, Academic Centre, Gartnavel Royal Hospital, Glasgow, UK. jc199d@clinmed.gla.ac.uk
Abstract
OBJECTIVE: We aimed to assess whether outcome followed a worse course after acute lithium withdrawal. METHOD: Data were acquired by review of the clinical records on 14 cases and 28 controls matched for age, gender and time on lithium for about 7 years following discontinuation. RESULTS: Significant differences were found between cases and controls. Cases experienced more episodes of depression and total affective relapse. The log-rank test revealed a significantly lower survival probability in cases than controls (P < 0.0009). However, the increased risk of recurrence was largely confined to the interval immediately after lithium discontinuation. CONCLUSION: These results confirm that acute discontinuation of lithium leads to a high immediate relapse rate. Most of the excess morbidity over 7 years appears to be attributable to the first episode following discontinuation. Outcome was not worsened by discontinuation.
OBJECTIVE: We aimed to assess whether outcome followed a worse course after acute lithium withdrawal. METHOD: Data were acquired by review of the clinical records on 14 cases and 28 controls matched for age, gender and time on lithium for about 7 years following discontinuation. RESULTS: Significant differences were found between cases and controls. Cases experienced more episodes of depression and total affective relapse. The log-rank test revealed a significantly lower survival probability in cases than controls (P < 0.0009). However, the increased risk of recurrence was largely confined to the interval immediately after lithium discontinuation. CONCLUSION: These results confirm that acute discontinuation of lithium leads to a high immediate relapse rate. Most of the excess morbidity over 7 years appears to be attributable to the first episode following discontinuation. Outcome was not worsened by discontinuation.
Authors: L G Sylvia; N A Reilly-Harrington; A C Leon; C I Kansky; J R Calabrese; C L Bowden; T A Ketter; E S Friedman; D V Iosifescu; M E Thase; M J Ostacher; M Keyes; D Rabideau; A A Nierenberg Journal: Acta Psychiatr Scand Date: 2013-10-03 Impact factor: 6.392