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Lithium: balancing risks and benefits

Published online by Cambridge University Press:  03 January 2018

John Cookson
John Cookson*
Affiliation:
The Royal London Hospital St Clement's, 2A Bow Road, London E3 4LL
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Extract

More than 20 years have passed since publication of the pivotal studies of efficacy upon which our use of lithium in acute mania and the prophylaxis of bipolar disorder are based. Since then, two of the most important discoveries about lithium have been the phenomenon of lithium withdrawal mania, and the recognition of permanent neurological sequelae after lithium toxicity. The use of lithium survived earlier criticism from the Institute of Psychiatry (Blackwell & Shepherd, 1968), but the new discoveries call for a reappraisal of the studies and reconsideration of whether lithium has a place in treatment, for which patients it should be recommended, what information and supervision should be given to patients on lithium, and what doctors should be expected to know of it.

Type
Evidece-Based Psychiatry
Information
The British Journal of Psychiatry , Volume 171 , Issue 2 , August 1997 , pp. 120 - 124
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

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References

REFERENCES

Amdisen, A. (1984) In Depression and Mania: Modern Lithium Therapy (ed. N. Johnson), pp. 24–28. Oxford: IRL Press.Google Scholar
Baldessarini, R. J., Tondo, L., Faedda, G. L., et al (1996) Effects of the rate of discontinuing lithium maintenance treatment in bipolar disorders. Journal of Clinical Psychiatry, 57, 441–448.CrossRefGoogle ScholarPubMed
Biederman, J., Lerner, Y. & Belmaker, R. H. (1979) Combination of lithium carbonate and haloperidol in schizoaffective disorder. Archives of General Psychiatry, 36, 327–333.CrossRefGoogle Scholar
Blackwell, B. & Shepherd, M. (1968) Prophylactic lithium. Another therapeutic myth? Lancet, i, 968–971.CrossRefGoogle Scholar
Bowden, C. L. (1995) Predictors of response to divalproex and lithium. Journal of Clinical Psychiatry, 56 (suppl. 3), 25–30.Google Scholar
Bowden, C. L., Brugger, A. M., Swann, A. C., et al (1994) Efficacy of divalproex vs. lithium and placebo in the treatment of mania. Journal of the American Medical Association, 271, 918–924.Google Scholar
Cookson, J. C., Silverstone, T. & Wells, B. (1981) A double-blind comparative clinical trial of pimozide and chlorpromazine in mania: a test of the dopamine hypothesis. Acta Psychiatrica Scandinavica, 64, 381–397.CrossRefGoogle Scholar
Coppen, A. & Abou-Saleh, M. T. (1983) Lithium in prophylaxis of unipolar depression: a review. Journal of the Royal Society of Medicine, 76, 297–301.Google Scholar
Coppen, A. & Abou-Saleh, M. T. (1988) Lithium therapy. From clinical trials to practical management. Acta Psychiatrica Scandinavica, 78, 754–762.Google Scholar
Coppen, A., Noguera, R., Bailey, J., et al (1971) Prophylactic lithium in affective disorders: Controlled trial. Lancet, ii, 275–279.Google Scholar
Coppen, A., Standish-Barry, H., Bailey, J., et al (1991) Does lithium reduce the mortality of recurrent mood disorders? Journal of Affective Disorders, 23, 1–7.Google Scholar
Coxhead, M., Silverstone, T. & Cookson, J. C. (1992) Carbamazepine versus lithium in the prophylaxis of bipolar affective disorder. Acta Psychiatrica Scandinavica, 85, 114–118.CrossRefGoogle ScholarPubMed
Davis, J. M., Wang, Z. & Janicak, P. G. (1993) A quantitative analysis of clinical drug trials for the treatment of affective disorders. Psychopharmacology Bulletin, 29, 175–181.Google Scholar
Dukes, M. N. G. (1996) Meylers side Effects of Drugs: An Encyclopaedia of Adverse Reactions and Interactions (13th edn). Amsterdam: Elsevier.Google Scholar
Dunner, D. L. & Fieve, R. R. (1974) Clinical factors in lithium prophylaxis failure. Archives of General Psychiatry, 30, 229–233.Google Scholar
Editorial (1987) Doubts about the value of maintenance lithium. Lancet, i. 424.Google Scholar
Faedda, G. L., Baldessarini, R. J., Tohen, M., et al (1991) Episode sequence in bipolar disorder and response to lithium treatment. American Journal of Psychiatry, 148, 1237–1239.Google Scholar
Gitlin, M. J. & Altshuler, L. L. (1997) Unanswered questions, unknown future for one of our oldest medications. Archives of General Psychiatry, 54, 21–23.CrossRefGoogle ScholarPubMed
Glick, I. D., Clarkin, J. F., Spencer, J. H., et al (1985) A controlled evaluation of inpatient family intervention: Preliminary results of the six-month follow-up. Archives of General Psychiatry, 42, 882–886.Google Scholar
Goodwin, F. K. & Ebert, M. (1973) Lithium in mania. Clinical trials and controlled studies. In Lithium: Its Role in Psychiatric Research and Treatment (eds S. Gershon & B. Shopsin), pp. 237–252. New York: Plenum Press.Google Scholar
Goodwin, F. K. & Jamison, K. R. (1990) Manic–Depressive Illness. Oxford: Oxford University Press.Google Scholar
Goodwin, F. K., Murphy, D. C. & Bunney, W F. (1969) Lithium carbonate treatment in depression and mania: A longitudinal double-blind study. Archives of General Psychiatry, 21, 486–496.CrossRefGoogle Scholar
Goodwin, G. M. (1994) Recurrence of mania after lithium withdrawal. Implications for the use of lithium in the treatment of bipolar affective disorder. British Journal of Psychiatry, 164, 149–152.Google Scholar
Goodwin, G. M. (1995) Lithium revisited: A reply. British Journal of Psychiatry, 167, 573–574.CrossRefGoogle Scholar
Grof, P., Alda, M., Grof, E., et al (1993) The challenge of predicting response to stabilising lithium treatment. British Journal of Psychiatry, 163 (suppl. 21). 16–19.CrossRefGoogle Scholar
Guscott, R. & Taylor, L. (1994) Lithium prophylaxis in recurrent affective illness: Efficacy, effectiveness and efficiency. British Journal of Psychiatry, 164, 741–746.Google Scholar
Hansen, H. E. & Amdisen, A. (1978) Lithium intoxication (Report of 23 cases and a review of 100 cases from the literature). Quarterly Journal of Medicine, 47, 123–144.Google Scholar
Himmelhoch, J. M., Mulla, D., Neil, J. F., et al (1976) Incidence and significance of mixed affective states in a bipolar population. Archives of General Psychiatry, 33, 1062–1066.Google Scholar
Himmelhoch, J. M., Neil, J. F., May, S. J., et al (1980) Age, dementia, dyskinesias, and lithium response. American Journal of Psychiatry, 137, 941–945.Google Scholar
Johnson, G. F. S., Hunt, G. E., Duggin, G. G., et al (1984) Renal function and lithium treatment: initial and follow-up tests in manic depressive patients. Journal of Affective Disorders, 6, 249–263.CrossRefGoogle ScholarPubMed
Johnstone, E. C., Crow, T. J., Frith, C. D., et al (1988) The Northwick Park “functional” psychosis study: Diagnosis and treatment response. Lancet, ii. 119–125.Google Scholar
Kato, T., lnbushi, T. & Takahashi, S. (1994) Relationship of lithium concentrations in the brain measured by lithium-7 magnetic resonance spectroscopy to treatment response in mania. Journal of Clinical Psychopharmacology, 14, 330–335.Google Scholar
Keck, R. E., McElroy, S. L., Strakowski, S. M., et al (1996) Factors associated with maintenance anti-psychotic treatment of patients with bipolar disorder. Journal of Clinical Psychiatry, 57, 147–151.Google Scholar
Licht, R. W., Gouliea, G., Vestergaard, R., et al (1994) Treatment of manic episodes in Scandinavia; the use of neuroleptic drugs in a clinical routine setting. Journal of Affective Disorders, 32, 179–185.Google Scholar
Littlejohn, R., Leslie, F. & Cookson, J. C. (1994) Depot anti-psychotics in the prophylaxis of bipolar affective disorders. British Journal of Psychiatry, 165, 827–829.Google Scholar
Lusznat, R. M., Murphy, D. P. & Nunn, C. M. H. (1988) Carbamazepine vs. lithium in the treatment and prophylaxis of mania. British Journal of Psychiatry, 153, 198–204.Google Scholar
Maggs, R. (1963) Treatment of manic illness with lithium carbonate. British Journal of Psychiatry, 109, 56–65.Google Scholar
Mander, A. J. & Loudon, J. B. (1988) Rapid recurrence of mania following abrupt discontinuation of lithium. Lancet, ii, 15–17.Google Scholar
Marks, I. M., Swinson, R. P., Basogtu, M., et al (1993) Alprazolam and exposure alone and combined in panic disorder with agoraphobia: A controlled study in London and Toronto. British Journal of Psychiatry, 162, 776–787.CrossRefGoogle ScholarPubMed
McCreadie, R. G. & Morrison, D. P. (1985) The impact of lithium in South-West Scotland. British Journal of Psychiatry, 146, 70–74.Google Scholar
McElroy, S. L., Keck, P. E., Stanton, S. P., et al (1996) A randomised comparison of divalproex oral loading vs. haloperidol in the initial treatment of acute psychotic mania. Journal of Clinical Psychiatry, 57, 142–146.Google Scholar
Moncrieff, J. (1995) Lithium revisited: a re-examination of the placebo-controlled trials of lithium prophylaxis in manic-depressive disorder. British Journal of Psychiatry, 167, 569–574.Google Scholar
Moncrieff, J. (1997) Lithium: evidence reconsidered. British Journal of Psychiatry, 171, 113–119.Google Scholar
Muller-Oerlinghausen, B., Ahren, B., Grof, E., et al (1992) The effects of long-term lithium treatment on the mortality of patients with manic–depressive and schizo-affective illness. Acta Psychiatrica Scandinavica, 86, 218–222.Google Scholar
Murphy, D. L. & Beigel, A. (1974) Depression, elation, and lithium carbonate responses in manic patient sub-groups. Archives of General Psychiatry, 31, 643–648.Google Scholar
Pecknold, J. (1993) The assessment of anxiety and benzodiazepine dependence. In Benzodiazepine Dependence (ed. C. Hallstrom), pp. 143–156. Oxford: Oxford University Press.Google Scholar
Pope, H. G., McElroy, S. I., Keck, P. E., et al (1991) Valproate in the treatment of acute mania: A placebo-controlled study. Archives of General Psychiatry, 48, 62–68.Google Scholar
Post, R. M. (1992) Anticonvulsants and novel drugs. In Handbook of Affective Disorders (ed. E. S. Paykel), pp. 387–417. Edinburgh: Churchill Livingstone.Google Scholar
Post, R. M., Jimerson, D. C., Bunney, W. F., et al (1980) Dopamine and mania: Behavioural and biochemical effects of the dopamine receptor blocker pimozide. Psychopharmacology, 67, 297–305.Google Scholar
Post, R. M., Rubinow, D. R., Uhde, T. W., et al (1989) Dysphoric mania: Clinical and biological correlates. Archives of General Psychiatry, 46, 353–358.Google Scholar
Price, L. H., Charney, D. S. & Heninger, G. R. (1986) Variability of response to lithium augmentation in refractory depression. American Journal of Psychiatry 143, 1387–1392.Google Scholar
Prien, R. F., Caffey, E. M. Jr & Klett, C. J. (1973) Prophylactic efficacy of lithium carbonate in manic–depressive illness. Archives of General Psychiatry, 28, 337–341.Google Scholar
Prien, R. F., Kupfer, D. J., Mansky, P. A., et al (1984) Drug therapy in the prevention of recurrences in unipolar and bipolar affective disorder: Report of the NIMH Collaborative Study Group comparing lithium carbonate, imipramine, and a lithium carbonate–imipramine combination. Archives of General Psychiatry, 41, 1096–1104.Google Scholar
Psaty, B. M., Koepsell, T. G., Wagner, E. H., et al (1990) The relative risk of incident coronary heart disease associated with recently stopping the use of beta-blockers. Journal of the American Medical Association, 263, 1653.Google Scholar
Rifkin, A., Doddi, S., Karajgi, B., et al (1994) Dosage of haloperidol for mania. British Journal of Psychiatry, 165, 113–116.CrossRefGoogle ScholarPubMed
Schou, M. (1979) Artistic productivity and lithium prophylaxis in manic–depressive illness. British Journal of Psychiatry, 135, 97–103.Google Scholar
Schou, M. (1964) Long-lasting neurological sequelae after lithium intoxication. Acta Psychiatrica Scandinavka, 70, 594–602.Google Scholar
Schou, M. (1997) Forty years of lithium treatment. Archives of General Psychiatry, 54, 9–13.Google Scholar
Schou, M., Juel-Nielson, N., Stromgren, E. & Voldby, K (1954) The treatment of manic psychoses by administration of lithium salts. Journal of Neurology. Neurosurgery and Psychiatry 17, 250–260.Google Scholar
Sellers, J., Tyrer, P., Whlteley, A., et al (1962) Neurotoxic effects of lithium with delayed rise in serum lithium levels. British Journal of Psychiatry, 140, 623–625.Google Scholar
Shull, W. K. & Sapira, J. D. (1970) Critique of studies of lithium salts in the treatment of mania. American Journal of Psychiatry 127, 218–222.Google Scholar
Souza, F. G. M. & Goodwin, G. M. (1991) Lithium treatment and prophylaxis in unipolar depression: a meta-analysis. British Journal of Psychiatry, 158, 666–675.Google Scholar
Stern, R. (1975) Lithium in the treatment of mood disorders. New England Journal of Medicine, 332, 127–128.Google Scholar
Stokes, P. E., Shamoian, C. A., Stoll, P. M., et al (1971) Efficacy of lithium as acute treatment of manic–depressive illness. Lancet, i. 1319–1325.Google Scholar
Stokes, P. E., Kocsis, J. H. & Arcuni, O. J. (1976) Relationship of lithium chloride dose to treatment response in acute mania. Archives of General Psychiatry 33, 1080–1084.Google Scholar
Stone, K. (1989) Mania in the elderly. British Journal of Psychiatry, 155, 220–224.Google Scholar
Suppes, T., Baldessarini, R., Faedda, G. L., et al (1991) Risk of recurrence following discontinuation of lithium treatment in bipolar disorder. Archives of General Psychiatry, 48, 1082–1088.Google Scholar
Swann, A. C., Secunda, S. K., Katz, M. M., et al (1986) Lithium treatment of mania: Clinical characteristics, specificity of symptom change, and outcome. Psychiatry Research, 18, 127–141.CrossRefGoogle ScholarPubMed
Waller, D. G. & Edwards, J. G. (1989) Lithium and the kidney: an update. Psychological Medicine, 19, 825–831.Google Scholar
West, A. P. & Meltzar, H. Y. (1979) Paradoxical lithium neurotoxicity: A report of five cases and a hypothesis about risk for neurotoxicity. American Journal of Psychiatry, 136, 963–966.Google Scholar
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