Controlled lithium discontinuation in bipolar patients with good response to long-term lithium prophylaxis

J Affect Disord. 2004 Jun;80(2-3):269-71. doi: 10.1016/S0165-0327(03)00133-2.


Background: This study aims to investigate whether the risk of recurrence following lithium discontinuation is less than reported in discontinuation of a successful, long-term prophylaxis in bipolar patients.

Methods: A total of 32 bipolar patients discontinued lithium according to the controlled lithium discontinuation (CLD) protocol following a definite good response to lithium maintenance of at least 5 years. Subjects were followed for up to 9 years.

Results: The total rate of recurrence was 7% in the first week, 32% in the first month, 62% in the first year, and 81% at the end of the 9th year following discontinuation. Only six of the 32 patients (19%) did not have a recurrence during the follow-up period.

Conclusions: Discontinuation of lithium seems to be followed by a high rate of recurrence in bipolar patients even after good response to a long-duration illness-free period. A controlled discontinuation protocol can reduce the risks of morbidity.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial

MeSH terms

  • Adult
  • Antipsychotic Agents / therapeutic use*
  • Bipolar Disorder / diagnosis
  • Bipolar Disorder / drug therapy*
  • Bipolar Disorder / prevention & control
  • Diagnostic and Statistical Manual of Mental Disorders
  • Drug Administration Schedule
  • Female
  • Follow-Up Studies
  • Humans
  • Lithium Carbonate / therapeutic use*
  • Male
  • Recurrence
  • Time Factors
  • Treatment Outcome


  • Antipsychotic Agents
  • Lithium Carbonate