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Lithium Prophylaxis of Bipolar Illness

The Value of Combination Treatment

Published online by Cambridge University Press:  02 January 2018

Eric D. Peselow ,
Ronald R. Fieve ,
Constance Difiglia  and
Michael P. Sanfilipo
Eric D. Peselow*
Affiliation:
Department of Psychiatry, New York University School of Medicine, 550 First Avenue, New York, NY 10010
Ronald R. Fieve
Affiliation:
Columbia College of Physicians and Surgeons, New York State Psychiatric Institute, 722 West 168th Street, New York, NY 10032
Constance Difiglia
Affiliation:
Foundation for Depression/Manic Depression, 7 East 67th Street, New York, NY 10016
Michael P. Sanfilipo
Affiliation:
Department of Psychiatry, New York Veterans Administration Medical Center, 423 East 23rd Street, New York, NY 10010, USA
*
∗ 1322 East 84th Street, Brooklyn, NY 11236, USA
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Abstract

Using a longitudinal life-table analysis, we assessed the efficacy of lithium alone, administered within the context of a naturalistic clinical setting, by calculating the probability of patients remaining free of an affective episode (manic or depressive) over a five-year course. In addition, for those who suffered a manic or depressive relapse, we attempted to analyse the subsequent course of patients who suffered a manic/hypomanic or depressive relapse and were then restabilised on lithium plus either a neuroleptic, carbamazepine, or a benzodiazepine, or lithium plus an antidepressant. Lithium alone offered an average 83% probability against an affective relapse after one year, 52% after three years, and 37% after five years. For patients who failed on lithium alone, it appeared that combination treatment offered greater protection against subsequent affective relapse than the initial course on lithium alone.

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Type
Papers
Information
The British Journal of Psychiatry , Volume 164 , Issue 2 , February 1994 , pp. 208 - 214
Copyright
Copyright © 1994 The Royal College of Psychiatrists 

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