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Lithium Treatment and Prophylaxis in Unipolar Depression: A Meta-analysis

Published online by Cambridge University Press:  02 January 2018

F. G. M. Souza  and
G. M. Goodwin
F. G. M. Souza
Affiliation:
Edinburgh University Department of Psychiatry and State University of Ceara, Messejana Mental Health Hospital, Fortaleza, Brazil
G. M. Goodwin*
Affiliation:
MRC Brain Metabolism Unit, Royal Edinburgh Hospital, Edinburgh
*
∗MRC Brain Metabolism Unit, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF
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Abstract

Meta-analysis was used to establish the efficacy of lithium in acute treatment and prophylaxis of depressive illness from existing published clinical trials. Effect sizes were measured by the odds ratio using the Mantel–Haenszel method and the Pearson product-moment correlation coefficient. Some benefit from lithium, compared with other treatments, emerged from trials of acute treatment. Lithium was clearly superior to placebo in the acute treatment of bipolar depressed patients. In controlled studies of lithium prophylaxis over five months to three years, an impressive effect was found for lithium when compared with placebo. For uncontrolled studies there was a similar-sized effect, corresponding to an improvement in the rate of favourable outcome from 35% for placebo to 70% with lithium treatment. The comparison of lithium with other antidepressants in prophylaxis showed no conclusive advantage for lithium in unipolar illness. There is no reason to doubt the efficacy of lithium in the prophylaxis of unipolar depressive illness.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 158 , Issue 5 , May 1991 , pp. 666 - 675
Copyright
Copyright © Royal College of Psychiatrists, 1991 

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