Discontinuation of lithium augmentation in an elderly cohort.
OBJECTIVE
To observe the effects of gradual discontinuation of lithium augmentation therapy in a group of patients over the age of 65 years and to measure the rate of relapse and to identify any factors which would predict relapse.


METHODS
This was a naturalistic study involving 21 patients who were on lithium augmentation and whose lithium was discontinued for a variety of clinical reasons. In most cases lithium was tapered and discontinued over a period of 2-12 weeks. Demographic and other variables were collected at baseline and compared between those who remained well and those that subsequently relapsed.


RESULTS
Eleven patients (52.4%) relapsed following discontinuation of lithium augmentation. Those who relapsed had been on lithium for significantly longer than those who remained well off lithium (p = 0.007). There was a trend towards more hospital admissions in the relapse group (p = 0.062).


CONCLUSIONS
When lithium augmentation therapy is discontinued in elderly depressives over half of these patients relapse. A longer duration of prediscontinuation lithium treatment and more hospital admissions appear to be associated with increased risk of relapse.
Fahy
S
S
Psychiatry of Old Age, Department of Psychiatry, St Camillus' Hospital, Shelbourne Road, Limerick, Ireland. sfahy@eircom.net
Lawlor
B A
BA
D000368:Aged; D000928:Antidepressive Agents / Q000008:administration & dosage* / Q000494:pharmacology; D015331:Cohort Studies; D003866:Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D005852:Geriatric Psychiatry; D006801:Humans; D016651:Lithium Carbonate / Q000008:administration & dosage* / Q000494:pharmacology; D008297:Male; D012008:Recurrence
D000928:Antidepressive Agents; D016651:Lithium Carbonate