Effects of the rate of discontinuing lithium maintenance treatment in bipolar disorders.

摘要: Background : Gradual discontinuation of lithium may reduce high risk early morbidity in bipolar disorder patients discontinuing successful long-term maintenance on lithium, but previous small samples have limited analyses subgroups. Method DSM-IV (N = 161) were pooled from similar maintained for 4.2 ± 3.1 years. Effects treatment abruptly (1-14 days) or gradually (15-30 compared by survival analysis clinically closely groups. Results After gradual versus rapid discontinuation, the overall median time to recurrence SE differed 5.0-fold (20.0 5.8 vs. 4.0 0.7 months ; p <.0001). remission was 2.3 times shorter than mean cycling interval before (6.3 14.6 The proportion subjects falling ill/month (recurrence rate) much higher first year after (6.5% 2.3%), thereafter (0.4% 0.6%) remained stable 3 years when off 20 more frequently (37% 1.8% Ratios gradual/rapid a mania and depression (4.4- 3.4-fold), insignificantly (34%) with continuous greater Type II I (9.8- 4.0-fold). polarity off-lithium lifetime episodes matched 70% cases. Conclusion These results strengthen concept pharmacodynamic stress factor relapse stopping support conclusion that can be minimized both disorders.