Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-20T01:09:11.875Z Has data issue: false hasContentIssue false
  • English
  • Français

The Challenge of Predicting Response to Stabilising Lithium Treatment

The importance of patient selection

Published online by Cambridge University Press:  06 August 2018

P. Grof ,
M. Alda ,
E. Grof ,
D. Fox  and
P. Cameron
P. Grof*
Affiliation:
Affective Disorders Program
M. Alda
Affiliation:
Department of Psychiatry, University of Ottawa, Royal Ottawa Hospital, Ottawa, Ontario, Canada
E. Grof
Affiliation:
Department of Psychiatry, University of Ottawa, Royal Ottawa Hospital, Ottawa, Ontario, Canada
D. Fox
Affiliation:
Department of Psychiatry, University of Ottawa, Royal Ottawa Hospital, Ottawa, Ontario, Canada
P. Cameron
Affiliation:
Department of Psychiatry, University of Ottawa, Royal Ottawa Hospital, Ottawa, Ontario, Canada
*
∗Correspondence
Get access Rights & Permissions [Opens in a new window]

Abstract

Lithium treatment, an approach with well documented efficacy, has recently been losing its treatment value. Lithium continues working, however, for those patients for whom it was proven efficacious; that is, most patients with primary episodic affective disorders. Such responders to lithium prophylaxis can be reliably identified beforehand by a comprehensive clinical assessment. The explanation for the paradox of lithium's lost efficacy lies mostly in the educational bias against a comprehensive patient assessment, and in the shift in diagnostic fashion favouring affective disorders and the treatment methods associated with them in the clinicians' minds.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 163 , Issue S21: Prediction in Psychopharmacology , September 1993 , pp. 16 - 19
Copyright
Copyright © 1993 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM-III). Washington, DC: APA.Google Scholar
Baldessarini, R. J. (1970) Frequency of diagnoses of schizophrenia versus affective disorders from 1944 to 1968. American Journal of Psychiatry, 127, 759–763.CrossRefGoogle ScholarPubMed
Dahlstrom, W. G., Welsh, G. S. & Dahlstrom, L. E. (1975) An MMPI Handbook. Minneapolis: University of Minnesota Press.Google Scholar
Grof, E., Haag, M., Grof, P., et al (1987) Lithium response and the sequence of episode polarities: preliminary report on a Hamilton sample. Progress in Neuropsychopharmacology and Biological Psychiatry, 2, 199–203.Google Scholar
Grof, P. (1983) Response to longterm lithium treatment: research studies and clinical implications. In The Affective Disorders (eds J. M. Davis & J. W. Maas), pp. 357–366. Washington, DC: American Psychiatric Press.Google Scholar
Grof, P. (1985) The challenge of lithium discontinuation. In Psychiatry: the State of the Art, pp. 815–820. New York: Plenum Press.Google Scholar
Grof, P. (1987) Admission rates and lithium therapy. British Journal of Psychiatry (letter to the editor), 150, 264–265.CrossRefGoogle ScholarPubMed
Grof, P., Cakuls, P. & Dostal, T. (1971) Lithium drop-outs: a followup study of the patients who discontinued prophylactic lithium. International Journal of Pharmacopsychiatry, 5, 1.Google Scholar
Grof, P., Lane, J., MacCrimmon, D., et al (1979a) Clinical and laboratory correlates of the response to longterm lithium. In Origin, Prevention and Treatment of Affective Disorders (eds E. Stromgren & M. Schou), pp. 28–40. London: Academic Press.Google Scholar
Grof, P., MacCrimmon, D., Murphy, D., et al (1979b) Platelet monoamine oxidase in affective disorders. In Proceedings of the 1st Meeting of the CCNP, Montreal, 1978 (ed. McClure, D. J.). Montreal: Pfizer.Google Scholar
Grof, P., Hux, M., Dressler, B., et al (1982) Kidney function and response to lithium treatment. Progress in Neuropsychopharmacology and Biological Psychiatry, 6, 491–494.CrossRefGoogle ScholarPubMed
Grof, P., Hux, M., Grof, E., et al (1983a) Prediction of response to stabilizing lithium treatment. Pharmacopsychiatry, 16, 195–200.CrossRefGoogle ScholarPubMed
Grof, P., Lane, J., Hux, M., et al (1983b) Predicting the response to longterm lithium treatment: interim results of a prospective study. In The Prediction of Lithium Response (ed. H. Dufour), pp. 43–53. University of Marseille Press.Google Scholar
Grof, P. & Grof, E. (1990) Varieties of lithium benefit. Progress in Neuropsychopharmacology and Biological Psychiatry, 14, 689–696.Google Scholar
Kukopoulos, A. & Reginaldi, D. (1980) Recurrences of manic depressive episodes during lithium treatment. In Handbook of Lithium Therapy (ed. Johnson, F. N.), pp. 109–111. Lancaster: MTP Press.CrossRefGoogle Scholar
Mendels, J., Fraser, A. & Baron, J. (1976) Intraerythrocyte lithium ion concentration and longterm maintenance treatment. Lancet, i, 966.CrossRefGoogle Scholar
Prien, R. & Gelenberg, A. (1989) Alternatives to lithium for the preventative treatment of bipolar disorder. American Journal of Psychiatry, 146, 840–848.Google ScholarPubMed
Schou, M., Thomsen, K. & Baastrup, P. (1970) Studies on the course of recurrent endogenous affective disorders. International Pharmacopsychiatry, 5, 100–106.CrossRefGoogle Scholar
Schou, M., Thomsen, K. & Baastrup, P. (1975) Lithium prophylaxis of recurrent endogenous affective disorders. In Lithium Research and Therapy (ed. Johnson, F. N.), pp. 63–85. London: Academic Press.Google Scholar
Stoll, A. L., Tohen, M. & Baldessarini, R. J. (1992) Increasing frequency of the diagnosis of obsessive-compulsive disorder. American Journal of Psychiatry, 149, 638–640.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.