THE EFFECTS OF AMITRIPTYLINE AND LITHIUM ON A PATIENT WITH 48-HOUR RECURRENT DEPRESSIONS

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Abstract
A 61 yr old man with a 5 yr history of 48 h mood swing cycles (1 day depressed, 1 day euthymic) was treated with medications in a double blind trial. Placebo had no effect on his cycles, amitriptyline lessened the amplitude of depression on bad days but did not effect the 48 h periodicity, whereas lithium carbonate therapy terminated both affective symptoms and the cycle itself. After several months on Li, the patient discontinued the drug, but neither symptoms nor cycles returned. Forty-eight hour affective cycles are unusual, and this patient''s response to Li is particularly striking.

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