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Published on: January 28, 2012
Controlled lithium discontinuation in bipolar patients with good response to long-term lithium prophylaxis
Olcay Yazici1, Kaan Kora, Aslihan Polat
1Department of Psychiatry, Istanbul Faculty of Medicine, University of Istanbul, Istanbul 80200, Turkey. olyazici@msn.com
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.
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