[Overcoming resistance to lithium prophylaxis]

At least 30% of maniodepressive patients are resistant to the prophyloctic administration of lithium, i. e. the course of the disease is not affected at all or only to a minimal extent. The investigation tested the effect by adding carbamazepine to the hitherto ineffective administration of lithium in 20 maniodepressive patients with the bipolar form. The open study was arranged in a mirror-image fashion; two two-year periods were compared: administration of lithium alone with administration of lithium and carbamazepine. Lithium carbonate was administered, 600-1500 mg/day with serum levels of 0.45-0.95 mval/l and carbamazepine 200-1200 mg/day. When the above combination was administered, a substantial reduction of the number of both phases occurred as well as a reduction of hospital admissions. The combination of lithium and carbamazepine substantially improved the course in 80% of patients hitherto resistant to lithium: 35% of the patients had no further manifestations of the disease, 45% had a lower frequency, intensity and duration of the phases. In 20% of the patients the disease developed with unaltered intensity,