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8 - Lithium Discontinuation

Advantages of Gradual Tapering; Suicide Risk Following Discontinuation; Efficacy Upon Resumption

Published online by Cambridge University Press:  09 February 2024

Jonathan M. Meyer  and
Stephen M. Stahl
Jonathan M. Meyer
Affiliation:
University of California, San Diego
Stephen M. Stahl
Affiliation:
University of California, San Diego
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Summary

There are numerous reasons for lithium discontinuation, some patient driven and others motivated by clinician concerns [1]. Focused and early attention to common adverse effects may forestall a certain proportion of somatic complaints leading to lithium refusal, but patients may also stop lithium due to the inconvenience of daily medication; diminished perceived need for lithium during periods of euthymia; a desire to remain in a hypomanic or even manic state (e.g. because they feel more creative or productive, or miss the elevated mood); comparative lack of efficacy for depressive episodes compared with the significant impact on mania; a wish not to be reminded of the illness itself; and not wanting their mood to be regulated by medication [2–4].

Type
Chapter
Information
The Lithium Handbook
Stahl's Handbooks
 , pp. 428 - 441
Publisher: Cambridge University Press
Print publication year: 2023

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