Treatment of depressions resistant to tricyclic antidepressants, related drugs or MAO-inhibitors by lithium addition: review of the literature.

Although it might be premature to consider the efficacy of lithium addition in patients unresponsive to conventional antidepressant drug treatment as established, the evidence is suggestive. Besides 26 open studies, four out of six controlled investigations reported a positive effect of combined therapy administered in the indicated sequence. Three controlled studies confirmed the original observation of de Montigny et al. that improvement may occur within 48 hours. Successful lithium addition was reported in different types of depression and after pretreatment with tricyclic antidepressants, related compounds or MAO-inhibitors. Preliminary recommendations with respect to the practical use of lithium addition are made.