Long‐term lithium treatment

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Abstract
The prophylactic effect of Li was studied prospectively in 63 patients with recurrent affective disorders. Li treatment was started at recovery from a current episode of illness when the patients were able to participate in the decision to start long-term treatment. The median treatment time was 23.7 mo. and the mean serum Li concentration .apprx. 0.63 mmol/l. Comparison with equally long control periods before Li showed that the treatment resulted in statistically significant reductions in number of episodes, number of months ill, and number of months hospitalized. There were 40 (63%) responders (frequency of episodes during Li lower than before Li) and 23 (37%) non-responders (frequency of episodes during Li higher than or the same as before Li). Females responded slightly better than males. Responders scored significantly higher than non-responders in the psychasthenia and muscle tension subscales of the Karolinska Hospital Personality Inventory. Both responders and nonresponders showed falls in CPRS [Comprehensive Psychopathological Rating Scale] during Li treatment, the fall was statistically significant in the responders. During the first 4 mo. of Li treatment the responders showed a significant rise in serum Ca, while serum Ca remained unaltered in the non-responders. These variables may be predictive of response to long-term Li treatment. The low numbers of patients who discontinued treatment and the even serum levels of Li suggest that good compliance to treatment was achieved with the present approach.