Lithium treatment of depression

Abstract

Lithium carbonate in high doses was administered to 22 patients hospitalized for endogenous depression. A statistically significant difference in response was observed between bipolar and unipolar patients. All six with a prior history of mania responded to the drug, whereas only 7 of 16, or 44%, of those without such a history showed a favorable response. Among the 13 patients that responded to lithium, a dose of 1800 mg daily was well tolerated despite the development of mild neuromuscular side effects in many. A clinical response that first appeared between the 6th and 13th days of lithium administration generally plateaued by the end of 3 weeks. Following placebo substitution, symptoms reemerged in nine patients. This investigation has again shown that bipolar depressions are more responsive to lithium than are unipolar ones. It suggests that further efforts be made to identify those unipolar depressions having a high probability of responding to lithium.