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The Tail Suspension Test
Published on: January 28, 2012
[Lithium Withdrawal Symptoms - A Systematic Review]
Stefan Gutwinski1,2, Lea Fierley1, Stefanie Schreiter1
1Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Berlin, Deutschland.
Background:
Withdrawal symptoms of lithium have not been systematically assessed to date.
Aim:
Systematic review of withdrawal symptoms after discontinuation of pharmacological treatment with lithium.
Methods:
Systematic literature search in PubMed and reference lists of relevant articles. We included clinical trials and case reports.
Results:
Out of 249 articles, six met our inclusion criteria, entailing six trials and a case series. Four trials and three case reports point to the existence of a withdrawal syndrome after discontinuation of lithium. Occurrence of symptoms was not dependent on the primary disorder for which lithium was initiated. Frequently reported symptoms were irritability, restlessness and somatic symptoms like vertigo, dizziness or lightheadedness. Symptoms occurred within the first week and were generally mild and self-limiting within weeks.
Conclusion:
Current evidence indicates that withdrawal symptoms after discontinuation of lithium can occur. There is a need for controlled studies of high methodological quality in order to assess predictors of and prevention strategies for discontinuation syndromes.
