Lithium Prophylaxis in Recurrent Affective Disorders

Data are presented from psychiatric clinics in Glostrup, Prague and Zurich for 244 patients who suffered from recurrent affective disorders and were treated prophylactically with lithium. The disease course was followed by recording the numbers of psychotic episodes and hospital admissions and the durations of cycles and episodes.

Lithium effects were evaluated by two methods: (A) intra-individual comparisons of the disease course during lithium treatment and during control periods of similar length before lithium, and (B) multiple regression analyses of cycle and episode durations with lithium treatment as one of the variables.

Lithium treatment led to a pronounced and statistically significant reduction in the number of both episodes and hospital admissions. This was demonstrated at all three clinics and for each of the affective disorders, manic-depressive psychosis, recurrent depressive psychosis, and schizo-affective psychosis. The response to lithium treatment was independent of age at the start of lithium treatment, age at first episode, sex, and number of previous episodes.

The regression analyses confirmed previous observations on the course of recurrent affective psychoses. Duration of cycles decreased with increasing age at first episode and increasing number of previous episodes. There was a slight decrease of episode duration with increasing number of episodes.

Lithium treatment led to a statistically significant prolongation of the cycles, considerable in manic-depressive and recurrent depressive psychosis, and moderate in schizo-affective psychosis. In manic-depressive patients, there was a statistically significant shortening of episodes during lithium treatment.

The results afford strong evidence that lithium is an active prophylactic agent in recurrent affective disorders.

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