Prophylactic medication for unipolar depressive illness: the place of lithium carbonate in combination with antidepressant medication.
A meta-analysis of the controlled clinical trials comparing the efficacy of combined lithium-imipramine therapy with each drug alone in the prevention of relapse in patients with unipolar depressive illness shows the combination to be superior to lithium alone (for any relapse, p less than 0.05; for specifically depressive relapse, p less than 0.025) and imipramine alone (for any relapse, p less than 0.025; for specifically depressive relapse, p less than 0.05). The issue of statistical power in studies of this kind is discussed. A single case of unipolar depressive illness is described, in which combined lithium-tranylcypromine therapy was superior to either drug alone. A combination of lithium and an antidepressant should be considered for any patient suffering from this condition who fails to remain well on either drug alone.
Kim
H R
HR
Department of Psychiatry, Queen's University, Kingston, Ontario.
Delva
N J
NJ
Lawson
J S
JS
D000928:Antidepressive Agents / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003866:Depressive Disorder / Q000188:drug therapy / Q000517:prevention & control*; D004359:Drug Therapy, Combination; D006801:Humans; D007099:Imipramine / Q000627:therapeutic use; D008094:Lithium / Q000627:therapeutic use*; D016651:Lithium Carbonate; D008297:Male; D015201:Meta-Analysis as Topic; D008875:Middle Aged; D014191:Tranylcypromine / Q000627:therapeutic use
D000928:Antidepressive Agents; D016651:Lithium Carbonate; D014191:Tranylcypromine; D008094:Lithium; D007099:Imipramine