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Acta Psychiatr Scand. 2004 Feb;109(2):91-5.

Relapse into mania or depression following lithium discontinuation: a 7-year follow-up.

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  • 1University of Glasgow Department of Psychological Medicine, Academic Centre, Gartnavel Royal Hospital, Glasgow, UK.



We aimed to assess whether outcome followed a worse course after acute lithium withdrawal.


Data were acquired by review of the clinical records on 14 cases and 28 controls matched for age, gender and time on lithium for about 7 years following discontinuation.


Significant differences were found between cases and controls. Cases experienced more episodes of depression and total affective relapse. The log-rank test revealed a significantly lower survival probability in cases than controls (P < 0.0009). However, the increased risk of recurrence was largely confined to the interval immediately after lithium discontinuation.


These results confirm that acute discontinuation of lithium leads to a high immediate relapse rate. Most of the excess morbidity over 7 years appears to be attributable to the first episode following discontinuation. Outcome was not worsened by discontinuation.

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