Relapse into mania or depression following lithium discontinuation: a 7-year follow-up
Article first published online: 16 JAN 2004
Acta Psychiatrica Scandinavica
Volume 109, Issue 2, pages 91–95, February 2004
How to Cite
Cavanagh, J., Smyth, R. and Goodwin, G. M. (2004), Relapse into mania or depression following lithium discontinuation: a 7-year follow-up. Acta Psychiatrica Scandinavica, 109: 91–95. doi: 10.1046/j.1600-0447.2003.00274.x
- Issue published online: 16 JAN 2004
- Article first published online: 16 JAN 2004
- Accepted for publication November 18, 2003
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.