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Lithium Carbonate Prophylaxis Failure

Published online by Cambridge University Press:  29 January 2018

David L. Dunner*
Affiliation:
Department of Internal Medicine, New York State Psychiatric Institute; and Columbia University
Joseph L. Fleiss
Affiliation:
Division of Biostatistics, Columbia University School of Public Health; and Biometrics Research, New York State Psychiatric Institute
Ronald R. Fieve
Affiliation:
Department of Internal Medicine, New York State Psychiatric Institute; and Columbia University Department of Internal Medicine, New York State Psychiatric Institute; and Columbia University; From the New Tork State Psychiatric Institute and Columbia University College of Physicians and Surgeons
*
Please address correspondence to Dr Dunner, 722 West 168th Street, New York, NY 10032, USA.

Summary

Data from non-rapid-cycling bipolar (manic-depressive) patients who were receiving long-term treatment with lithium carbonate were analysed by the life table method to determine when lithium carbonate prophylaxis failures occurred. Forty-four of 96 patients failed to keep well in spite of maintenance lithium therapy. The analysis revealed an early, rapid failure rate during the first six months of treatment, which was followed by a slower rate of failure. Several clinical factors were assessed to determine if any of them predicted which patients would experience their initial failure in the early or late interval, but none of these factors, which included age, sex, age of onset, rate of affective attacks, family history, and the nature of the preceding episode, were found to have any predictive value regarding lithium prophylaxis failure. We found, however, that patients who had early failures tended to have a subsequent early failure in spite of continued maintenance with lithium carbonate.

Type
Research Article
Copyright
Copyright © Royal College of Psychiatrists, 1976 

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References

Dunner, D. L., Gershon, E. S. & Goodwin, F. K. (1970) Heritable factors in the severity of affective disorder. Scientific Proceedings of the American Psychiatric Association, 103, 187–8.Google Scholar
Dunner, D. L., & Fieve, R. R. (1974) Clinical factors in lithium carbonate prophylaxis failure. Archives of General Psychiatry, 30, 229–33.Google Scholar
Feighner, J. P., Robins, E., Guze, S. B., Woodruff, R. A. Jr., winokur, G. & Munoz, R. (1972) Diagnostic criteria for use in psychiatric research. Archives of General Psychiatry, 26, 5763.CrossRefGoogle ScholarPubMed
Fleiss, J., Dunner, D. L., Stallone, F. & Fieve, R. R. (1976) The life table: a method for analysis of longitudinal data. Archives of General Psychiatry, In press.Google Scholar
Greenwood, M. (1926) The errors of sampling of the survivorship tables. Report of Public Health and Medical Subjects No. 33, pp 23–5. London: hmso.Google Scholar
Mantel, N. (1966) Evaluation of survival data and two new rank order statistics arising in its consideration. Cancer Chemotherapy Reports, 50, 163–70.Google ScholarPubMed
Mendlewicz, J., Fieve, R. R. & Stallone, F. (1973) Relationship between the effectiveness of lithium therapy and family history. American Journal of Psychiatry, 130, 1011–13.Google Scholar
Mendlewicz, J., Fleiss, J. L., Cataldo, M. & Rainer, J. (1975) Accuracy of the family history method in affective illness. Archives of General Psychiatry, 32, 309–14.CrossRefGoogle ScholarPubMed
Stallone, F., Shelley, E., Mendlewicz, J. & Fieve, R. R. (1973) The use of lithium in affective disorders. III. A double-blind study of prophylaxis in bipolar illness. American Journal of Psychiatry, 130, 1006–10.Google Scholar
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