Abstract
A two year clinical experience with lithium has been described. Our results can be summarized as follows:
Effect on active mania
Over seventy per cent of the manic patients in this study were controllable with lithium alone.
An additional twenty per cent with severe mania had to be stabilized by haloperidol, but were maintained by lithium once the acute phase subsided.
When a patient maintained on lithium shows prodromal symptoms of hypomania an increase in the dose of lithium is often, and for some patients regularly, an effective control for the incipient manic attack.
Some patients required periodic treatment for residual depression. Decreasing the dose of lithium, and adding an anti-depressant has been found to be effective, even in some cases where an antidepressant alone had previously failed to prevent repeated depressions. Merely decreasing the dose of lithium was not found to be effective.
Those who relapsed completely tended to be more hostile and suspicious, and in the authors' experience, ultimately showed schizophrenic features.
One relapse, especially when subsequent to the patient's discontinuing his own medication, does not mean that the patient cannot thereafter, be stabilized on lithium. One relapse should not be taken to mean ultimate failure, when a decrease in severity or frequency of attacks would be a worthwhile goal.