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Lithium loses efficacy once stopped and restarted

Posted by Scott L. Schofield on January 26, 2000, at 11:29:40

Someone recently posted the following:

"Lithium has a reputation of losing its effectiveness when stopping and quitting. So, along my journey of med searches, I kept taking it."

A friend of mine who suffers from bipolar II remained symptom-free for over three years while receiving lithium monotherapy. During this time, she experienced no side-effects, and her thyroid and renal tests were normal. When she relocated, her new doctor decided that she had been taking lithium for long enough, and that it was about time to discontinue it. She weaned off of it gradually over the course of a month or two. She relapsed into severe depression within three months. Of course, the doctor decided to restart the lithium. Fifteen years of unsuccessful drug trials have passed since.


- Scott


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Am J Psychiatry 1992 Dec;149(12):1727-9

Lithium-discontinuation-induced refractoriness: preliminary observations.

Post RM, Leverich GS, Altshuler L, Mikalauskas K
Biological Psychiatry Branch, National Institute of Mental Health, Bethesda, MD 20892.

The authors used a systematic life-chart methodology to observe four patients with bipolar disorder in whom long periods (6-15 years) of effective lithium prophylaxis were followed by relapses on lithium discontinuation. Once the drug was reinstituted, it was no longer effective. The incidence, predictors, and mechanisms underlying this phenomenon all require further systematic study. The current preliminary observations suggest an additional reason for caution when lithium discontinuation in the well-maintained patient is considered.


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poster:Scott L. Schofield thread:19732
URL: http://www.dr-bob.org/babble/20000112/msgs/19732.html