Relapse prevention in manic depressive illness: important and unimportant factors

Many factors play a role in the safe and effective prevention of relapses. These include: selection of patients; organization of treatment; choice of drug; dosage and treatment regimen; clinical and laboratory monitoring; information and instruction given to patients and relatives; and psychotherapeutic and social support. Some of these factors have received much attention in the past, although perhaps not always the most important ones. This paper, a brief refresher course, discusses the priorities and precautions which must be considered when treating patients with manic depressive illnesses.