title: Lithium carbonate versus E.C.T. in the treatment of the manic state of identical twins with bipolar affective disease.
abstract: Scientific evidence accumulated to date of the efficacy of lithium in the treatment and prophylaxis of bipolar affective states rests primarily on quantitative vector analysis and some double blind studies. To our knowledge, no clinical studies similar to this one exist in literature wherein indentical twins were subjected to the variables of electroconvulsive therapy and phenothiazines versus lithium carbonate and phenothiazines. The only other variable in the study was the hospital settings involved. The twins' course of treatment over a period of 12 years prior to their presentation wherein they received phenothiazines in various hospital settings is presented in detail. The current study would seem to suggest that E.C.T. and phenothiazines are superior to phenothiazines alone in shortening hospital course and perhaps in improving post-hospital adjustment. Further, prior to the advent of lithium, it may be evident that psychiatrists were not attuned to the diagnosis of affective states. Finally, lithium carbonate and phenothiazines, while requiring a significantly longer period of hospitalization than E.C.T. and phenothiazines, appear to be associated with preventing re-hospitalization for manic states, but a slightly decreased level of occupational adjustment. The author discusses the potential value of these patients in determining the clinical efficacy of future drugs in bipolar affective states, as well as the necessity to obtain future studies of the creatinine phosphokinase level.
mesh_terms: D001714:Bipolar Disorder / Q000175:diagnosis / Q000235:genetics / Q000628:therapy*; D004200:Diseases in Twins; D004565:Electroconvulsive Therapy; D005260:Female; D006801:Humans; D008094:Lithium / Q000627:therapeutic use*; D011247:Pregnancy; D011599:Psychopathology; D014430:Twins, Monozygotic
chemical_list: D008094:Lithium