Discontinuation of lithium augmentation in an elderly cohort

Authors

  • Sabina Fahy,

    Corresponding author
    1. Senior Registrar in Psychiatry of Old Age, St Camillus' Hospital, Shelbourne Road, Limerick, Ireland
    • Senior Registrar in Psychiatry of Old Age, Department of Psychiatry of Old Age, St Camillus' Hospital, Shelbourne Road, Limerick, Ireland.
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  • Brian A. Lawlor

    1. Professor of Psychiatry for the Elderly, Trinity College Dublin, and St James's Hospital, Dublin, Ireland
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Abstract

Objectives

To observe the effects of gradual discontinuation of lithium augmentation therapy in a group of patients over the age of 65 years and to measure the rate of relapse and to identify any factors which would predict relapse.

Methods

This was a naturalistic study involving 21 patients who were on lithium augmentation and whose lithium was discontinued for a variety of clinical reasons. In most cases lithium was tapered and discontinued over a period of 2–12 weeks. Demographic and other variables were collected at baseline and compared between those who remained well and those that subsequently relapsed.

Results

Eleven patients (52.4%) relapsed following discontinuation of lithium augmentation. Those who relapsed had been on lithium for significantly longer than those who remained well off lithium (p = 0.007). There was a trend towards more hospital admissions in the relapse group (p = 0.062).

Conclusions

When lithium augmentation therapy is discontinued in elderly depressives over half of these patients relapse. A longer duration of prediscontinuation lithium treatment and more hospital admissions appear to be associated with increased risk of relapse. Copyright © 2001 John Wiley & Sons, Ltd.

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