Lithium Carbonate: Maintenance Studies and Consequences of Withdrawal

The treatment of mood disorders with lithium carbonate has made a significant impact on thehealth of patients who have these disorders and on the nature of psychiatry itself. Perhaps the single,most important finding about the efficacy of lithium that has influenced American psychiatry is thefact that lithium, given over long periods of time, reduces the frequency and severity of subsequentaffective episodes in manic depressive patients. This paper discusses the selection of patients formaintenance treatment, the dose of lithium, the maintenance treatment of patients who have breakthroughepisodes, those with hypomanic breakthrough episodes, and rapid cycling. The use of lithiumin unipolar depression and the elderly and the consequences of lithium discontinuation are also reviewed.