Pharmacological and Clinical Problems of Lithium Prophylaxis

Schou, Mogens; Baastrup, P. C.; Grof, Paul; Weis, Paola Souza Castro; Angst, J.

doi:10.1192/bjp.116.535.615

Cited by 153 publications

(41 citation statements)

References 17 publications

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“…Matussek and Hassling [12] have indicated that tremor is related to increases in lithium gradient and high lithium levels. This is in contrast to Schou [16] who found that 53% of 100 patients exhibited tremor in the 1st month of treatment as opposed to a 4% incidence of tremor after 1-2 years of treatment. Other investigators noted that nausea and abdominal pain were related to greater changes in lithium levels [1,2] while others found no relation between these side effects and blood level [9], Recently, Persson [13] found tremor associ ated with higher lithium levels and greater changes in lithium levels.…”

Section: Discussioncontrasting

confidence: 53%

Course and Relationship of Lithium Side Effects to Plasma Lithium Levels

et al. 1981

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49 patients with primary affective disorders maintained on lithium were evaluated over a 6-month course and the pattern of 10 well-known innocuous side effects of lithium therapy was closely evaluated. The patients had significantly more side effects in the 1 st month as opposed to the 4th through 6th months. The difference was statistically significant (with p less than 0.05). There was no difference in plasma lithium levels among individuals having no side effects, 1–2 side effects or 3 or more side effects at any point during the 6-month period.

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Section: Discussioncontrasting

confidence: 53%

Course and Relationship of Lithium Side Effects to Plasma Lithium Levels

et al. 1981

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“…Each of them reported, under different circumstances, that some manic patients who responded to lithium and continued on it remained free of further manias and depressions; a dramatic change compared to the patients' previous histories. Schou and Baastrup [20][21][22] then pursued these reflections systematically and the rest is history. The stabilizing treatment of bipolar disorder with lithium was born, along with many thousands of responders.…”

Section: The Next Stepsmentioning

confidence: 99%

Sixty Years of Lithium Responders

Grof¹

2010

Neuropsychobiology

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It has been 60 years since Cade first described patients who responded to antimanic lithium treatment. Two decades later, responders to lithium stabilization emerged in larger numbers. The responses of many severely ill bipolar patients to lithium were striking and called for an explanation. Remarkable reactions to a simple ion generated hope for an uncomplicated laboratory test of response and an extensive search for suitable biological markers ensued. But despite promising reports, particularly from molecular genetics, we are still waiting for a biological elucidation of the stabilizing effects of lithium. The most useful predictor of lithium stabilization has to date been the patient’s clinical profile, based on a comprehensive clinical assessment: complete remissions and other characteristics of episodic clinical course, bipolar family history, low psychiatric comorbidity and a characteristic presenting psychopathology. In brief, the responders approximate the classical Kraepelinian description of a manic-depressive patient. But the most intriguing findings have recently emerged from prospective observations of the next generation: the children of lithium responders, their counterparts coming from parents who did not respond to lithium and controls. Overall, they indicate that parents and offspring suffer from a comparable brain dysfunction that manifests clinically in distinct stages. If the child’s predicament starts early in childhood, it presents with varied, nonaffective or subclinical manifestations that are usually nonresponsive to standard treatments prescribed according to the symptoms. The next stage then unfolds in adolescence, first with depressive and later with activated episodes. The observations have a potential to markedly enrich the prevailing understanding and management of mood disorders.

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“…Schou et al . (20) reported that about 53 percent of patients showed lithium tremor within the first week of treatment. This was not a demonstrable finding in our stud y.…”

Section: Discussionmentioning

confidence: 99%