Although there remains some controversial issues in the prophylactic effect of lithium therapy of patients with affective disorders, the lithium maintenance therapy widely believed to reduce the frequency of both manic and depressive relapses as well as amount of time spent in hospital.
To investigate the effectiveness of lithium maintenance therapy, sixty one bipolar patients (25 males and 36 females) were selected, who had received lithium maintenance therapy in the Department of Neuropsychiatry, Korea University Hospital.
A comparison by intra-individual method was made between the period during which a patient was received an appropriate lithium carbonate and the corresponding period immediately preceding the initiation of lithium treatment. Average period of observation was about 3+3 years, and the patients in this trial had received lithium for more than 18 months
The following results were obtained:
1. The mean age at onset was 24.5, and male to female ratio was 1 : 1.4. In clinical type, mania was observed more in finale and depression was more in female.
2. During lithium maintenance therapy, the average relapsing frequency of annual episodes were reduced from 1.160.09 to 0.610.07 and the duration also reduced from 9.340.76 to 4.740.66 weeks compared with pre-lithium period.
The number of admission to hospital during the period of lithium treatment was 0.31 0.05 compared with pre-lithium period of 0.310.09. Hospitalization period also dropped from 5.460.63 to 2.250.42 weeks.
Statiscal analysis of the data by the t-test indicated highly significant difference between the pre-lithium and lithium treatment period.
3. The mild side effects associated lithium maintenance therapy were found in sixteen (26.256) patients. Among these, nausea and vomiting(50.0%), and oral dryness (12.5%) were found most frequently.
4. As to the clinical effects of the lithium maintenance therapy, twenty eight(47.9%) patients were good responded and thirty four (39.3%) were moderate, but six (9.8%) were poor. Three of the patients had died during observation period.
Two of them had died with depression and one patient died with unknown cause.
5. The range of serum lithium level of maintenance therapy was 0. 69 0. 1 OmEq/L with 900mg to 1, 500mg of daily doses.
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