Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-28T01:15:09.206Z Has data issue: false hasContentIssue false
  • English
  • Français

The early signs of manic relapse after lithium discontinuation and their clinical implications

Published online by Cambridge University Press:  13 June 2014

A J Mander
A J Mander*
Affiliation:
Royal Park Hospital, Private Bag 3, P.O. Parkville, Victoria 3052, Australiaformerly Lecturer, University Dept. of Psychiatry, Royal Edinburgh Hospital, Edinburgh, Scotland
Get access Rights & Permissions [Opens in a new window]

Abstract

The earliest signs and symptoms of manic relapse in eight bipolar patients after lithium discontinuation were changes in talkativeness, motor performance, self-confidence and sleep pattern; only two patients reported a change in mood. These changes were initially subtle and did not occur in patients who stayed well after stopping lithium. The lack of affective symptoms might result in clinicians ascribing the changes to the removal of the sedative and cognitive slowing properties of lithium, rather than signs of an impending relapse; similar changes may well occur in patients whose relapse is not associated with lithium discontinuation. Prompt early treatment with lithium (and additional thioridazine in some cases) resulted in only two patients requiring readmission, both for ten days. It is concluded that such symptoms may indicate an impending relapse and prompt treatment is recommended.

Keywords

Manic Depressive IllnessLithium DiscontinuationSymptoms
Type
Clinical and Brief Reports
Information
Irish Journal of Psychological Medicine , Volume 7 , Issue 1 , March 1990 , pp. 42 - 44
Copyright
Copyright © Cambridge University Press 1990

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Mander, AJ, Loudon, JB. Rapid recurrence of mania following abrupt discontinuation of lithium. Lancet 1988; ii: 15–17.CrossRefGoogle Scholar
2.American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-III). 3rd ed. Washington DC: APA, 1980.Google Scholar
3.Blackburn, IM, Loudon, JB, Ashworth, CM. A new scale for measuring mania. Psychological Medicine 1977; 17: 453–458.CrossRefGoogle Scholar
4.Kocsis, JH, Shaw, ED, Hatterer, Jet al.Motor and cognitive performance on lithium: relationship to thyroid function. In: Birch, NJ ed. Lithium: inorganic pharmacology and psychiatric use. Oxford: IRL Press 1988: 149–153.Google Scholar
5.Jacobsen, JE. The hypomanic alert: a programme designed for greater therapeutic control. Am J Psychiatry 1965; 122: 295–299.CrossRefGoogle Scholar
6.Greil, W, Schmidt, St. Lithium withdrawal reactions. In: Birch, NJ, ed. Lithium: inorganic pharmacology and psychiatric use. Oxford: IRL Press, 1988: 149–153.Google Scholar
7.Tondo, L, Floris, G, Burrai, Cet al.Lithium withdrawal: an outcome. In: Birch, NJ ed. Lithium: inorganic pharmacology and psychiatric use. Oxford: IRL Press, 1988: 155–156.Google Scholar