The combat of non‐compliance during prophylactic lithium treatment

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Abstract
Non‐compliance is the most frequent cause of recurrence during prophylactic lithium treatment and is associated with poor response and high levels of suicidality. Non‐compliance is a complex phenomenon and may have a number of causes. When manic‐depressive patients fare badly under the conditions of so‐called ‘naturalistic' trials, this usually indicates that such conditions are inadequate for long‐term maintenance treatment. Prophylactic lithium treatment must be accompanied by measures to sustain compliance and counteract drop‐out, and these measures build on three cornerstones, namely information, support and supervision.