title: Lithium-discontinuation-induced refractoriness: preliminary observations.
abstract: The authors used a systematic life-chart methodology to observe four patients with bipolar disorder in whom long periods (6-15 years) of effective lithium prophylaxis were followed by relapses on lithium discontinuation. Once the drug was reinstituted, it was no longer effective. The incidence, predictors, and mechanisms underlying this phenomenon all require further systematic study. The current preliminary observations suggest an additional reason for caution when lithium discontinuation in the well-maintained patient is considered.
authors.affiliation: Biological Psychiatry Branch, National Institute of Mental Health, Bethesda, MD 20892.
authors.forename: R M
authors.initials: RM
authors.lastname: Post
authors.forename: G S
authors.initials: GS
authors.lastname: Leverich
authors.forename: L
authors.initials: L
authors.lastname: Altshuler
authors.forename: K
authors.initials: K
authors.lastname: Mikalauskas
mesh_terms: D001714:Bipolar Disorder / Q000139:chemically induced / Q000517:prevention & control* / Q000523:psychology; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D004565:Electroconvulsive Therapy; D006801:Humans; D008094:Lithium / Q000009:adverse effects* / Q000627:therapeutic use; D012008:Recurrence; D012307:Risk Factors; D013375:Substance Withdrawal Syndrome / Q000209:etiology* / Q000523:psychology
chemical_list: D008094:Lithium