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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.

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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