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Lithium Augmentation in Antidepressant-Resistant Patients a Quantitative Analysis

Published online by Cambridge University Press:  02 January 2018

M.-P. V. Austin
Affiliation:
Edinburgh University Department of Psychiatry, Royal Edinburgh Hospital
F. G. M. Souza
Affiliation:
Edinburgh University Department of Psychiatry, and Assistant Professor, State University of Ceara, Messejana Mental Health Hospital, Fortaleza, Brazil
G. M. Goodwin*
Affiliation:
MRC Brain Metabolism Unit, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF
*Corresponding
Correspondence

Abstract

A quantitative analysis was used to examine the efficacy of lithium augmentation in the acute treatment of depressed patients resistant to a standard trial of an antidepressant. Effect sizes were measured by the odds ratio using the Mantel–Haenszel method. Only controlled trials were included in order to minimise bias in method. A highly statistically significant effect for lithium augmentation was found, the pooled odds ratio being 0.146 and its 95% confidence interval 0.05–0.44 (i.e. the odds of remaining ill are reduced by between 56% and 95% with the use of lithium treatment). While these results support the case for lithium augmentation in treatment-resistant depression, there remains considerable uncertainty over the duration of treatment necessary to see and sustain the treatment response.

Type
Papers
Copyright
Copyright © 1991 The Royal College of Psychiatrists 

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References

Blier, P. & de Montigny, C. (1985) Short-term lithium administration enhances serotonergic neurotransmission: electrophysiological evidence in the rat CNS. European Journal of Pharmacology, 112, 415418.Google Scholar
Cournoyer, G., de Montigny, C., Ouellete, J., et al (1984) Lithium addition in tricyclic-resistant unipolar depression: a placebo-controlled study. Abstracts Collegium Internationale Neuro-Psychopharmacologicum Florence, June 19—23, 179.Google Scholar
de Montigny, C. & Aghajanlan, G. K. (1978) Tricyclic antidepressants: long-term treatment increases responsivity of rat forebrain neurons to serotonin. Science, 202, 13031306.CrossRefGoogle ScholarPubMed
de Montigny, C., Grunberg, F., Mayer, A., et al (1981) Lithium induces rapid relief of depression in tricyclic antidepressant drug non-responders. British Journal of Psychiatry, 138, 252256.CrossRefGoogle ScholarPubMed
de Montigny, C., Cournoyer, G., Morisette, R., et al (1983) Lithium carbonate addition in tricyclic antidepressant-resistant unipolar depression. Archives of General Psychiatry, 40, 13271333.CrossRefGoogle ScholarPubMed
Dinan, T. G. & Barry, S. (1989) A comparison of electroconvulsive therapy with a combined lithium and tricyclic combination among depressed tricyclic non-responders. Acta Psychiatrica Scandinavica, 80, 97100.CrossRefGoogle Scholar
Gardner, M. J. & Altman, D. G. (1990) Confidence — and clinical importance — in research findings. British Journal of Psychiatry, 156, 472474.CrossRefGoogle ScholarPubMed
Glass, G. V. (1977) Integrating findings: the meta-analysis of research. Review of Research in Education, 5, 351379.Google Scholar
Goodwin, F. K., Prange, A. J., Post, R. M., et al (1982) Potentiation of antidepressant effects by L-triiodothyronine in tricyclic non-responders. American Journal of Psychiatry, 139, 3438.Google Scholar
Heninger, G. R., Charney, D. S. & Sternberg, D. E. (1983) Lithium carbonate augmentation of antidepressant treatment: an effective prescription for treatment-refractory depression. Archives of General Psychiatry, 40, 13351342.CrossRefGoogle ScholarPubMed
Himmelhoch, J. M., Detre, T., Kupfer, D. J., et al (1972) Treatment of previously intractable depressions with tranylcypromine and lithium. Journal of Nervous and Mental Disease, 155, 216220.CrossRefGoogle ScholarPubMed
Kantor, D., McNevin, S., Leichner, P., et al (1986) The benefit of lithium carbonate adjunct in refractory depression: fact or fiction? Canadian Journal of Psychiatry, 31, 416418.CrossRefGoogle ScholarPubMed
Mantel, N. & Haenszel, W. (1959) Statistical aspects of the analysis of data from retrospective studies of disease. Journal of the National Cancer Institute, 22, 719748.Google Scholar
Nolen, W. A., van de Putte, J. J., Dijken, W. A., et al (1988) Treatment strategy in depression — I. Non-tricyclic and selective reuptake inhibitors in resistant depression: a double-blind partial cross-over study on the effects of oxaprotiline and fluvoxamine. Acta Psychiatrica Scandinavica, 718, 668675.CrossRefGoogle Scholar
Pare, C. M. B. (1963) Potentiation of monoamine oxidase inhibitors by tryptophan. Lancet, i, 527528.CrossRefGoogle Scholar
Price, L. H., Charney, D. S. & Heninger, G. R. (1986) Variability of response to lithium augmentation in refractory depression. American Journal of Psychiatry, 143, 13871392.Google ScholarPubMed
Price, L. H. & Charney, D. S. (1987) Reserpine augmentation of desipramine. Psychopharmacology, 92, 431437.CrossRefGoogle ScholarPubMed
Schöpf, J. (1989) Treatment of depressions resistant to tricyclic antidepressants, related drugs or MAO-inhibitors by lithium addition: review of the literature. Pharmacopsychiatry, 22, 174182.CrossRefGoogle ScholarPubMed
Schöpf, J., Baumann, P., Lemarchand, T., et al (1989) Treatment of endogenous depressions resistant to tricyclic antidepressants or related drugs by lithium addition. Pharmacopsychiatry, 22, 183187.CrossRefGoogle ScholarPubMed
Schou, M. (1990) Lithium and treatment-resistant depressions: a review. Lithium, 1, 38.Google Scholar
Stein, G. & Bernadt, M. (1988) Double blind trial of lithium carbonate in tricyclic resistant depression. In Lithium: Inorganic Pharmacology and Psychiatric Use (ed. Birch, N. J.). Oxford: IRL Press.Google Scholar
Thase, M. E., Kupfer, D. J., Frank, E., et al (1989) Treatment of imipramine-resistant recurrent depression: II. An open clinical trial of lithium augmentation. Journal of Clinical Psychiatry, 50, 413417.Google ScholarPubMed
Wharton, R. N., Perel, J. M., Dayton, P. G., et al (1971) A potential clinical use for methylphenidate (Ritalin) with tricyclic antidepressants. American Journal of Psychiatry, 127, 16191625.CrossRefGoogle ScholarPubMed
World Psychiatric Association (1974) Symposium on therapy-resistant depression. Pharmacopsychiatry, 7, 69224.Google Scholar
Yusuf, S., Peto, R., Lewis, J., et al (1985) Beta-blockade during and after myocardial infarction: an overview of the randomised trials. Progress in Cardiovascular Diseases, 27, 335371.CrossRefGoogle Scholar
Zusky, P. M., Biederman, J., Rosenbaum, J. F., et al (1988) Adjunct low dose lithium carbonate in treatment-resistant depression: a placebo-controlled study. Journal of Clinical Psychopharmacology, 8, 120124.CrossRefGoogle ScholarPubMed
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