Lithium in bipolar disorder

Suppes, T, Baldessarini, R.J., and Faedda, G.L. (1991) Risk of recurrence following discontinuation of lithium in bipolar disorder. Arch Gen Psychiatry 48 1082-1088. 

During 2004 a number of clinical trials were reported involving acute and maintenance studies of lithium, mostly either comparing new atypical antipsychotic drugs with lithium in bipolar disorder or in combined treatment studies. Of the relatively few studies of the adverse effects of lithium, most clustered in the areas of cardiovascular effects and issues regarding lithium toxicity. 

Goodwin GM, Geddes GR. Latest maintenance data on lithium in bipolar disorder. Eur Neuropsychopharmacol. 2003 13(Suppl 2) S51-5. 

Maj M. The effect of lithium in bipolar disorder a review of recent research evidence. Bipolar Disord. 2003 5 180-8. 

Treatment discontinuation of several psychotropic agents has been proposed to increase the risk of recurrence of morbidity to a degree greater than would be predicted by the natural history of untreated illness this risk probably extends over several months. Evidence for this phenomenon is particularly strong with lithium in bipolar disorder, is likely with some antipsychotics, and may occur with antidepressants. Such risk may be reduced by gradual discontinuation of long-term medication over at least several weeks see Chapter 18). 

Kessing LV, Hellmimd G, Anderson PK. An observational nationwide register based cohort study of lamotrigine versus lithium in bipolar disorder. J Psychopharmacol 2012 26(5) 644-52. 

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