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Relapse into mania or depression following lithium discontinuation: a 7‐year follow‐up
Author(s) -
Cavanagh J.,
Smyth R.,
Goodwin G. M.
Publication year - 2004
Publication title -
acta psychiatrica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.849
H-Index - 146
eISSN - 1600-0447
pISSN - 0001-690X
DOI - 10.1046/j.1600-0447.2003.00274.x
Subject(s) - discontinuation , mania , lithium (medication) , depression (economics) , medicine , bipolar disorder , pediatrics , psychiatry , psychology , economics , macroeconomics
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.