Long-term clinical effectiveness of lithium maintenance treatment in types I and II bipolar disorders
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Background: The effectiveness of lithium is being questioned increasingly and requires clarification. Aims: To assess the effectiveness of lithium treatment in depression and mania, syndromal types I and II, with predominantly mixed or psychotic episodes or rapid cycling, during treatment resumed following discontinuation, and across three decades. Method: The longitudinal course of 360 patients with bipolar disorder compliant with lithium treatment for at least 1 year and without comorbidity for substance use disorder was reviewed. Results: Risk of single-episode recurrences, a common index of treatment failure, was similar to that in other reports. Both episode frequency and ‘time ill’ improved more in type II than type I cases. Reduced morbidity during treatment was similar in patients with mixed or psychotic episodes, or rapid cycling, and in less complex cases. Retreatment yielded minor decrements in response, and there was no tendency for lesser responses in more recent years. Conclusions: Based on overall affective morbidity, long-term lithium treatment in compliant patients without comorbid substance use disorder, though imperfect, remains effective, even in subgroups of supposedly poor prognosis.
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In that 6-year study, the proportion of time with mood symptoms was significantly lower for BDII than for BDI.
“The authors noted that the proportion of time with mood symptoms was significantly lower for BDII than for BDI.”
In a 6-year study of patients with BDI or BDII (39% with BDII), lithium reduced time in hypomania/mania by 61% and time in depression by 53% in the entire sample compared with the period before lithium treatment was initiated.
“In a 6‐year study of patients with either BDI or BDII (39% with BDII), lithium reduced time in hypomania/mania by 61% and time in depression by 53% in the entire sample, compared with the period before lithium treatment was initiated.498”
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- Authors
- Tondo, L., Baldessarini, R. J., & Floris, G.
- Affiliations
- Harvard University (US)
- University of Cagliari (IT)
- Corresponding author
- Tondo, Leonardo
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2001-06
- Volume
- 178
- Issue
- S41
- Pages
- s184-s190
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2115737172
- Cited by
- 132
- References
- 75
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 3 · 2023: 4 · 2022: 3 · 2021: 1 · 2020: 7 · 2019: 3 · 2018: 10 · 2017: 2 · 2016: 5 · 2015: 5 · 2014: 5 · 2013: 3 · 2012: 6
- FWCI
- 4.74
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Alliance for Research on Schizophrenia and Depression
- Bruce J. Anderson Foundation
- National Institutes of Health (5k05mh047370-25, MH-47370)
- National Institute of Mental Health (MH47370)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- lithium, bipolar disorder, maintenance therapy, long-term treatment effectiveness, bipolar I disorder, bipolar II disorder, mixed states, psychotic episodes, rapid cycling, relapse, episode frequency, medication adherence, substance use disorders
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