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The Challenge of Predicting Response to Stabilising Lithium Treatment

The importance of patient selection

Published online by Cambridge University Press:  06 August 2018

P. Grof ,
M. Alda ,
E. Grof ,
D. Fox  and
P. Cameron
P. Grof*
Affiliation:
Affective Disorders Program
M. Alda
Affiliation:
Department of Psychiatry, University of Ottawa, Royal Ottawa Hospital, Ottawa, Ontario, Canada
E. Grof
Affiliation:
Department of Psychiatry, University of Ottawa, Royal Ottawa Hospital, Ottawa, Ontario, Canada
D. Fox
Affiliation:
Department of Psychiatry, University of Ottawa, Royal Ottawa Hospital, Ottawa, Ontario, Canada
P. Cameron
Affiliation:
Department of Psychiatry, University of Ottawa, Royal Ottawa Hospital, Ottawa, Ontario, Canada
*
∗Correspondence
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Abstract

Lithium treatment, an approach with well documented efficacy, has recently been losing its treatment value. Lithium continues working, however, for those patients for whom it was proven efficacious; that is, most patients with primary episodic affective disorders. Such responders to lithium prophylaxis can be reliably identified beforehand by a comprehensive clinical assessment. The explanation for the paradox of lithium's lost efficacy lies mostly in the educational bias against a comprehensive patient assessment, and in the shift in diagnostic fashion favouring affective disorders and the treatment methods associated with them in the clinicians' minds.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 163 , Issue S21: Prediction in Psychopharmacology , September 1993 , pp. 16 - 19
Copyright
Copyright © 1993 The Royal College of Psychiatrists 

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