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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
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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

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