No abstract

The problem of lithium maintenance treatment and weight gain was examined in 70 manic-melancholic patients who had been in treatment for 2 to 10 years. Their case records were reviewed and they answered a questionnaire. Out of 70 patients, 45 increased in weight with a mean weight gain of about 10 kg. The patients who increased in weight during the treatment were overweight already before the start and reached a weight about 20% higher than their ideal weight. They nearly all found themselves overweight and took measures to slim. No connection between a history of infant obesity and weight gain was found. Increase in appetite was only found in one third of the patients and had only a weak influence on the degree of weight gain. Nearly all the patients felt an increased thirst, and a very clear correlation between liquid intake and weight gain was found. It is recommended that all patients are repeatedly warned of the risks involved in satisfying their increased thirst on lithium by fluids rich in calories.

A group of 50 long-term lithium-treated outpatients were investigated with psychological examinations in order to study cognitive and emotional functions (memory, attention, speed, loss of effort, level of processing, productivity, and reactivity). The test results were compared with the general norms for the test applied. In average the test results were within the normal range. The inter-test variations which quantitatively and qualitatively characterize the performance of the lithium-treated patients indicate a relative lowering of the level of memory and perceptual processing as well as loss of effort when compared to the level of attention, productivity, and emotional reactivity. These findings support the hypothesis of a lithium-determined delay of the rate of information processing, a hypothesis which may be related to neuropsychological model of the level of arousal.