Discontinuation of lithium treatment in remitted bipolar patients: relationship between clinical outcome and changes in sleep-wake cycles.
In this preliminary report, we describe four patients in whom long-term lithium therapy was discontinued, combined with actigraphic monitoring to assess changes in motor activity and the sleep-wake cycle. Two patients experienced rapid relapse of manic symptomatology, while two remained stable throughout a 1-year follow-up. Actigraphic monitoring revealed disintegration of the sleep-wake cycle and increased motor activity in the relapsed patients only. It is suggested that actigraphic recordings can be used to monitor lithium discontinuation.
Klein
E
E
Department of Psychiatry, Rambam Medical Center, Haifa, Israel.
Mairaz
R
R
Pascal
M
M
Hefez
A
A
Lavie
P
P
D000553:Ambulatory Care; D001714:Bipolar Disorder / Q000139:chemically induced / Q000188:drug therapy* / Q000503:physiopathology; D004311:Double-Blind Method; D006801:Humans; D008094:Lithium / Q000008:administration & dosage* / Q000009:adverse effects; D008991:Monitoring, Physiologic / Q000295:instrumentation; D009043:Motor Activity; D010919:Placebos; D012008:Recurrence; D012890:Sleep; D013375:Substance Withdrawal Syndrome / Q000209:etiology; D014851:Wakefulness
D010919:Placebos; D008094:Lithium