Eleven patients with major affective disorder (DSM-III) were investigated after a mean of 6.7 years on lithium prophylaxis and reinvestigated 7 years later, at which time they had discontinued lithium for a mean 2.3 years. Outcome was assessed by the Comprehensive Psychopathological Rating Scale, by relapse frequencies, by need for psychotropic medication and for inpatient treatment. The study period was associated with an increase in the rated score for depression, as previously observed also in lithium continuers. Although the relapse frequencies remained largely unchanged, a significantly increased number of inpatient treatment days indicated considerably more severe episodes after the discontinuation of lithium. Long periods without lithium were associated with higher doses of neuroleptic drugs.