Abstract
Three man, aged 66, 60 and 26 years with bipolar disorder and long periods (20-5 years) of effective lithium prophylaxis had relapses on lithium discontinuation. Once the drug was reinstituted, it was no longer effective. Combinations of lithium with a classical MAO inhibitor or a second mood stabilizer (valproic acid and carbamazepine, respectively) ultimately proved to be successful. The risk of refractoriness should be kept in mind before considering to stop lithium therapy. A better compliance can be achieved by informing patients about the risks of discontinuing lithium, by maintaining a minimal maintenance dose and by adequately coping with possible side effects.
Publication types
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Case Reports
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English Abstract
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Review
MeSH terms
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Adult
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Aged
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Antidepressive Agents / pharmacology
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Antidepressive Agents / therapeutic use*
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Antimanic Agents / pharmacology
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Antimanic Agents / therapeutic use*
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Bipolar Disorder / drug therapy*
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Bipolar Disorder / prevention & control*
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Carbamazepine / therapeutic use
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Dose-Response Relationship, Drug
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Drug Therapy, Combination
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Drug Tolerance
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Humans
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Lithium / pharmacology
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Lithium / therapeutic use*
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Male
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Middle Aged
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Monoamine Oxidase Inhibitors / pharmacology
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Monoamine Oxidase Inhibitors / therapeutic use*
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Treatment Outcome
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Valproic Acid / therapeutic use
Substances
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Antidepressive Agents
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Antimanic Agents
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Monoamine Oxidase Inhibitors
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Carbamazepine
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Valproic Acid
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Lithium