Long‐term therapy with lithium in a private practice clinic: a naturalistic study

Abstract

Controlled studies in psychopharmacology are obviously preferred to open-label or naturalistic case studies. However, controlled studies are rarely conducted over long periods, and practice-related naturalistic research can be of value, albeit anecdotal and without the use of structured rating scales. In this paper, we are reporting on 14 patients seen consistently by one psychiatrist. These patients were functional and productive at work and in family life. The patients suffered brief hypomanic or depressive episodes. Although several patients experienced serious side-effects, lithium was continued with stable mood, while the side-effects were managed in collaboration with other specialists.

Long‐term outcome of patients with bipolar disorder commenced on lithium prophylaxis during hospitalization: a complete 15‐year register‐based follow‐up

“…Additionally, complete 15.3‐year follow‐up information on death and hospitalizations was available on all patients through the unique registers of the Danish health system. A relatively long duration of follow‐up of 15.3 years is also more than has been achieved in other similar cohorts followed systematically, although case series with longer periods of observation have been published (19). The major weakness of the present study is the lack of information during follow‐up on morbidity beyond hospitalizations for affective symptoms.…”

An approach to long-term sedative-hypnotic use

“…However, a similar deficit in knowledge exists regarding the long-term use of antidepressants, and even shorter-term use is not without serious side effects 80–83. We therefore think it is misguided to use a different class of drugs simply for the side effect of inducing sleep.…”

Who are excellent lithium responders and why do they matter?

“…Clinically, many lithium responders do not stabilize on other treatments; when they are unable to stay on lithium, for instance because of poor tolerability, finding an effective replacement often becomes difficult. The search for clinical predictors of lithium response is still going on, but several factors are emerging repeatedly out of different studies.…”