[Risk of inducing resistance upon stopping and restarting lithium after long-term usage].
Three man, aged 66, 60 and 26 years with bipolar disorder and long periods (20-5 years) of effective lithium prophylaxis had relapses on lithium discontinuation. Once the drug was reinstituted, it was no longer effective. Combinations of lithium with a classical MAO inhibitor or a second mood stabilizer (valproic acid and carbamazepine, respectively) ultimately proved to be successful. The risk of refractoriness should be kept in mind before considering to stop lithium therapy. A better compliance can be achieved by informing patients about the risks of discontinuing lithium, by maintaining a minimal maintenance dose and by adequately coping with possible side effects.
Oostervink
F
F
Academisch Ziekenhuis, Utrecht.
Nolen
W A
WA
Hoenderboom
A C
AC
Kupka
R W
RW
D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D018692:Antimanic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000517:prevention & control*; D002220:Carbamazepine / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D004361:Drug Tolerance; D006801:Humans; D008094:Lithium / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D008996:Monoamine Oxidase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome; D014635:Valproic Acid / Q000627:therapeutic use
D000928:Antidepressive Agents; D018692:Antimanic Agents; D008996:Monoamine Oxidase Inhibitors; D002220:Carbamazepine; D014635:Valproic Acid; D008094:Lithium