Lithium Prophylaxis in Recurrent Affective Disorders

Abstract

Following the first reports of a prophylactic lithium action in recurrent affective disorders (Hartigan, 1963; Schou, 1963; Baastrup, 1964; Schou and Baastrup, 1966; Baastrup and Schou, 1967), a large number of research projects on this subject have been started. Prophylactic studies yield results slowly, and reports published to date are mainly of a preliminary nature. Some have been negative; the authors found little or no evidence of prophylactic lithium action (Fieve et al., 1968; Zall et al., 1968). Other observations seem to confirm the ability of lithium to prevent manic and depressive relapses (Achté et al., 1968; Blinder, 1968; Christodoulou, 1968; Dyson and Mendels, 1968; Gershon, 1968; Gottfries, 1968; Haastrup et al., 1968; Hofmann and Boleloucky-Bolen, 1968; Hullin et al., 1968; Kerry and Owen, 1968; Lauter, 1969; Levy, 1968; Melia, 1968; Sargant, 1968; Vaadal and Robak, 1968; Annell, 1969; Forssman and Wålinder, 1969; Fries, 1969; Uddenberg, 1969). The reports are based on samples which range from a few patients to about seventy. Few deal with systematic studies.

The Early Natural History of Bipolar Disorder: What We Have Learned from Longitudinal High-Risk Research

“…44 The nature of the clinical course has been recognized as a predictor of response to specific mood stabilizers. [45][46][47] Further, the nature of the clinical course is one of the characteristics differentiating BD subtypes and is related to differential pathophysiological correlates, family history, treatment response, and prognosis. [48][49][50][51][52] In our experience, customizing treatment by incorporating the clinical profile of the individual patient (for example, nature of the clinical course, the family history of psychiatric disorders, and the familial response to treatment) into the selection of the mood stabilizer for that patient improves their outcome dramatically, compared with outcomes from randomly chosen treatments listed in generic treatment guidelines.…”

The Role of Brain 5‐hydroxytryptamine in the Hyperactivity Produced in Rats by Lithium and Monoamine Oxidase Inhibition

“…Lithium has been used with benefit in the treatment of mania (Cade, 1949;Schou, 1959;Gershon & Yuwiler, 1960) and there are studies suggesting prophylactic activity in manicdepressive illness and unipolar depression (Schou & Baastrup, 1967;Angst, Weis, Grof, Baastrup & Schou, 1970;Baastrup, Poulsen, Schou, Thomsen & Amdisen, 1970;Coppen, Noguera, Bailey, Burns, Swarin, Hare, Gardner & Maggs, 1971). The use of lithium in the therapy of these disorders came about empirically, but hopefully, an understanding of the mechanisms of action of lithium should throw light not only upon the processes by which it exerts its therapeutic effect but also upon the pathogenesis of these psychiatric illnesses.…”

Has the Effectiveness of Lithium Changed? Impact of the Variety of Lithium's Effects

“…Both acute and long-term "antipsychotic" effects have been described best by Garver and his group (Garver et al 1984 in schizophrenias and schizophreniform psychoses, and illustrated on schizoaffective psychoses by many others (e.g., Angst et al 1970;Lenz et al 1987;Lenz et al 1989) and can commonly be seen clinically. During treatment with lithium alone, a dramatic clearing of psychotic symptoms has been seen in acute psychoses (schizoaffective and schizophreniform), even in mood incongruent ones, and in many patients, continued treatment with lithium alone could prevent further episodes.…”