Prediction of Rapid Relapse Following Lithium Discontinuation

Abstract

AbstractAll twenty-nine bipolar 1 patents who satisfied DSM-111 criteria following their first hospitalisation for mania and subsequently discontinued their prophylactic lithium after a mean of 29 ± 21 months were studied. Patients were classified into poor prognosis (relapsed within 3 months of discontinuation, n = 8) and good prognosis groups (relapsed after 3 months or did not relapse, n = 21). Poor prognosis patients were more likely to have been prescribed additional psychotropic medication in the previous year (P = 0.026) and had higher serum lithium levels immediately prior to lithium discontinuation (P = 0.0043). Recent additional psychotropic medication may indicate that the patient is at an increased risk of early relapse if lithium prophylaxis is being stopped for any reason. The increased risk for those patients with higher lithium levels suggest that gradual phased reductions would be prudent.