Lithium Maintenance Treatment of Manic‐melancholic Patients: Its Role in the Daily Routine

Abstract

The purpose of this study was to evaluate the desired and undesired effects of relapse-preventive lithium treatment given routinely to manic-melancholic patients who had accepted the necessity of a strict tablet regime. The evaluation was based upon case record data and various rating scales, and 76 patients took part in the investigation. Our results showed that in 24% of the patients treatment was discontinued. This was due to side effects in 16% and to insufficient effect in 8% of the cases. The suicide risk was not eliminated, and 29% of the patients were receiving additional antidepressive or antimanic treatment at the test day. On the other hand, 78% of the patients rated the relapse-preventive lithium effect as moderate to excellent. Indirect evidence was obtained in support of a stabilizing effect of lithium on the emotional control in bipolar patients. The most frequent complaints during lithium treatment were tremor and increased thirst.

The Profile and Severity of Lithium-Induced Side Effects in Mentally Healthy Subjects

“…In the present study we have used both questionnaires and observer scales con structed on the basis of clinically reported lithium-induced side effects. Although there are certain limitations in using mentally healthy subjects when evaluating side effects induced by psychopharmacological drugs (Bech, 1975), we have here investigated patients without psychiatric disorders, as supplementary treat ment in form of antipsychotic and antidepressive drugs is often needed in lithium mainte nance treatment of manic-melancholic patients (Bech et al, 1976b) thus invalidating the evalu ation of genuine lithium-induced side effects.…”

Assessment of Treatment Adherence in Patients with Bipolar Disorder

“…In the literature, the rate of non-adherence with medication of patients with BD ranges between 20 to 60% (24,25). The rate of poorly adherent patients in our study suicide attempters may be due to these factors.…”

The Full Story of Lithium

“…The low suicidal risk during long-term lithium therapy was confi rmed by Petterson [32] . We found that 78% of the patients had experienced a moderate to excellent clinical effect of lithium [31] .…”

“…In 1976, our group at the Psychiatric Institute of the Danish National Hospital in Copenhagen published [31] results of prophylactic lithium treatment of patients with bipolar disorder who had been treated in our out-patient clinic from 1968 to 1972. This clinic had specialised in patients with affective disorders and was headed by Ole Rafaelsen.…”