Undue Mood Elevation in Unipolar Patients following Cessation of Lithium Augmentation Treatment: Implications for the Understanding of Mood Disorders

Abstract

Objective: The precipitation of hypomania or mania in some patients with apparent unipolar (UP) depression by the use of antidepressants, lithium augmentation, or antidepressant withdrawal has been described in the literature. However, only 4 cases have been reported where undue mood elevation in UP patients followed lithium termination. To add to the literature, we report 2 cases where mood elevation followed cessation of lithium augmentation treatment. Method: Observations were continued on 2 patients receiving an antidepressant plus lithium augmentation after cessation of the lithium treatment. Result: There was undue mood elevation in these patients immediately following lithium termination. Conclusion: This observation supports the view that there is extensive vulnerability to bipolar disorder among patients with multiple depressions.