Lithium and recurrence in a long-term follow-up of bipolar affective disorder

W Coryell; G Winokur; D Solomon; T Shea; A Leon; M Keller

doi:10.1017/S0033291796004461

Back

Lithium and recurrence in a long-term follow-up of bipolar affective disorder

Journal article

Peer reviewed

Lithium and recurrence in a long-term follow-up of bipolar affective disorder

W Coryell, G Winokur, D Solomon, T Shea, A Leon and M Keller

Psychological medicine, Vol.27(2), pp.281-289

03/1997

DOI: 10.1017/S0033291796004461

PMID: 9089821

View Online

Abstract

Though previous studies have clearly shown that lithium affords prophylaxis in bipolar affective disorder, these studies have not demonstrated the persistence of this prophylactic effect beyond the first year of recovery. One hundred and eighty-one patients with bipolar affective disorder recovered during 5 years of semi-annual follow-up. After 8 weeks of recovery, 139 were taking lithium prophylaxis and 42 were not. Analyses used drug status (lithium v. no-lithium) as a censoring variable to compare these two groups by interval-specific probabilities of recurrence. Recurrence was initially less likely in the lithium group but interval-specific probabilities of recurrence did not consistently favour either group after the first 32 weeks of recovery. Biases in treatment decisions may have both reduced the size and altered the specificity of the lithium effects seen here. Nevertheless, the apparent transience of lithium prophylactic effects is unexplained and may reflect important, physiological differences between relapse and recurrence. This possibility invites a controlled lithium discontinuation study, with gradual taper, of patients who have had at least 8 months of sustained euthymia.

Recurrence

Antimanic Agents - therapeutic use

Follow-Up Studies

Humans

Middle Aged

Male

Treatment Outcome

Bipolar Disorder - diagnosis

Bipolar Disorder - drug therapy

Bipolar Disorder - psychology

Lithium Carbonate - therapeutic use

Psychiatric Status Rating Scales

Adult

Female

Antimanic Agents - adverse effects

Lithium Carbonate - adverse effects

Details

Title: Subtitle: Lithium and recurrence in a long-term follow-up of bipolar affective disorder
Creators: W Coryell - Department of Psychiatry, University of Iowa College of Medicine, Iowa City, USA
G Winokur
D Solomon
T Shea
A Leon
M Keller
Resource Type: Journal article
Publication Details: Psychological medicine, Vol.27(2), pp.281-289
Publisher: England
DOI: 10.1017/S0033291796004461
PMID: 9089821
ISSN: 0033-2917
eISSN: 1469-8978
Grant note: R01 MH025478 / NIMH NIH HHS
Language: English
Date published: 03/1997
Academic Unit: Psychiatry
Record Identifier: 9984003911602771

Metrics

30 Record Views

42 Times Cited - Web of Science

See more details