Controlled lithium discontinuation in bipolar patients with good response to long-term lithium prophylaxis.
BACKGROUND
This study aims to investigate whether the risk of recurrence following lithium discontinuation is less than reported in discontinuation of a successful, long-term prophylaxis in bipolar patients.


METHODS
A total of 32 bipolar patients discontinued lithium according to the controlled lithium discontinuation (CLD) protocol following a definite good response to lithium maintenance of at least 5 years. Subjects were followed for up to 9 years.


RESULTS
The total rate of recurrence was 7% in the first week, 32% in the first month, 62% in the first year, and 81% at the end of the 9th year following discontinuation. Only six of the 32 patients (19%) did not have a recurrence during the follow-up period.


CONCLUSIONS
Discontinuation of lithium seems to be followed by a high rate of recurrence in bipolar patients even after good response to a long-duration illness-free period. A controlled discontinuation protocol can reduce the risks of morbidity.
Yazici
Olcay
O
Department of Psychiatry, Istanbul Faculty of Medicine, University of Istanbul, Istanbul 80200, Turkey. olyazici@msn.com
Kora
Kaan
K
Polat
Aslihan
A
Saylan
Mete
M
D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000517:prevention & control; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016651:Lithium Carbonate / Q000627:therapeutic use*; D008297:Male; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D016651:Lithium Carbonate