Abstract
In order to test the efficacy of lithium therapy for alcoholism, to test whether lithium therapy reduces depressive symptoms among alcoholics, and to test whether any positive lithium treatment effects are associated with an antidepressant action, we undertook a double-blind placebo-controlled study of 122 patients meeting DSM-III criteria for alcohol dependence and hospitalized for alcoholism rehabilitation. We used survival analysis to examine the cumulative proportion of each treatment group that remained abstinent (i. e., “survived”) over the course of 18 months, using complete abstinence from alcohol as the principal outcome measure.
Our findings add support to the hypothesis that lithium carbonate promotes abstinence from alcohol and delays the time to first drink. Patients treated with lithium were much less likely to be rehospitalized for alcoholism rehabilitation during the 18-month follow-up. These effects did not appear to be related to the treatment of concomitant or underlying affective symptoms. We found no support, on the other hand, for the hypothesis that lithium therapy reduces the frequency of drinking for relapse drinkers.
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References
Kline NS, Wren JC, Cooper TB, Varga E, Canal O: Evaluation of lithium therapy in chronic and periodic alcoholism. Am J Med Sci 268: 15–20, 1974.
Wren JC, Kline NS, Cooper TB, Varga E, Canal O: Evaluation of lithium therapy in chronic alcoholism. Clin Med 81: 33–36, 1974.
Flemenbaum A: Affective disorders and “chemical dependence”: Lithium for alcohol and drug addiction? Dis Nerv Syst 35: 281–285, 1974.
Merry J, Reynolds CM, Bailey J, Coppen A: Prophylactic treatment of alcoholism by lithium carbonate. Lancet 2: 481–482, 1976.
Young LD, Keeler MH, Martin M: Sobering data in lithium in alcoholism. Lancet 1: 144, 1977.
Crane DL: Manic depressive disease in alcoholism, in Seixas FA (ed): Currents in Alcoholism, Vol. 2. New York, Grune and Stratton, 1977, pp 53–58.
Ho AD, Tsai CS: Effects of lithium on alcohol preference and withdrawal. Ann NY Acad Sci 273: 371–377, 1976.
Judd LL, Huey LY: Lithium antagonizes ethanol intoxication in alcoholics. Am J Psychiatry 141: 1517–1521, 1984.
Moos RH, Finney JW: The expanding scope of alcoholism treatment evaluation. Am Psychol 38: 1036–1044, 1983.
Fuller RK, Williford WO: Life-table analysis of abstinence in a study evaluating the efficacy of disulfiram. Alcohol Clin Exp Res 4: 298–301, 1980.
Poikolainen K: Survival methods in the evaluation of the outcome of alcoholism treatment. Br J Addictions 78: 403–407, 1983.
Hollingshead AD: Four Factor Index of Social Status. Unpublished data, 1975.
Fawcett J, Clark DC, Gibbons RD, Aagesen CA, Pisani V, Tilkin JM, Sellers D, Stutzman D: Evaluation of lithium therapy for alcoholism. J Clin Psychiatry 45: 494–499, 1984.
Fawcett J, Clark DC, Aagesen CA, Pisani VD, Tilkin JM, Sellers D, McGuire M, Gibbons RD: A double-blind, placebo-controlled trial of lithium carbonate therapy for alcoholism. Arch Gen Psychiatry 44: 248–256, 1987.
Endicott J, Spitzer R: A diagnostic interview: The Schedule for Affective Disorders and Schizophrenia. Arch Gen Psychiatry 33: 766–771, 1976.
Spitzer R, Endicott J, Robins E: Research Diagnostic Criteria: Rationale and reliability. Arch Gen Psychiatry 35: 773–782, 1978.
Andreasen NC, Endicott J, Spitzer RL, Winokur G: The family history method using diagnostic criteria. Arch Gen Psychiatry 34: 1229–1235, 1977.
Hamilton M: A rating scale for depression. J Neurol Neurosurg Psychiatry 23: 56–62, 1960.
Endicott J, Nee J, Fleiss J, et al: Hamilton Depression Rating Scale: Extracted from regular and change versions of the Schedule for Affective Disorders and Schizophrenia. Arch Gen Psychiatry 8: 98–103, 1981.
Beck A, Beamesderfer A: Assessment of depression: The Depression Inventory. Mod Probl Pharmacopsychiatry 7: 151–169, 1974.
Endicott J, Spitzer RL, Fleiss JL, Cohen J: The Global Assessment Scale: A procedure for measuring overall severity of psychiatric disturbance. Arch Gen Psychiatry 33: 766–771, 1976.
Weissman MM, Bothwell S: Assessment of social adjustment by patient self-report. Arch Gen Psychiatry 33: 1111–1115, 1976.
Shipley W: A self-administering scale for measuring intellectual impairment and deterioration. J Psychol 9: 371–377, 1940.
Paulson M, Lin T: Predicting WAIS IQ from Shipley-Hartford scores. J Clin Psychol 29: 1–9 (monograph Suppl), 1970.
Andreasen N, Grove W, Shapiro R, et al: Reliability of lifetime diagnosis: A multicenter collaborative perspective. Arch Gen Psychiatry 38: 400–405, 1981.
Keller MB, Lavori PW, Andreasen NC, Grove WM, Shapiro RW, Scheftner W, McDonald-Scott P: Test-related reliability of assessing psychiatrically ill patients in a multi-center design. J Psychiatr Res 16: 213–227, 1981.
Keller M, Lavori P, McDonald-Scott P, et al: Reliability of lifetime diagnoses and symptoms in patients with a current affective disorder. J Psychiatr Res 16: 229–240, 1981.
Breslow N: A generalized Kruskal-Wallis test for comparing K samples subject to unequal patterns of censorship. Biometrika 57: 579–594, 1970.
Robins E, Munoz RA, Marten S, Gentry KA: Primary and secondary affective disorders, in Zubin J, Freyman FA (eds): Disorders of Mood. Baltimore, John Hopkins University Press, 1972.
McClellan AT, Luborsky L, Woody GE, et al: Predicting response to alcoholic and drug abuse treatments: Role of psychiatric severity. Arch Gen Psychiatry 40: 620–625, 1983.
Sackett DL, Gent M: Controversy in counting and attributing events in clinical trials. N Engl J Med 301: 1410–1412, 1979.
Jerram TC, McDonald R: Plasma lithium control with particular reference to minimum effective levels, in Johnson FN, Johnson S (eds): Lithium in Medical Practice: Proceedings of the First British Lithium Congress. Baltimore, University Park Press, 1980, pp 243–247.
Hullin RP: Minimum serum lithium levels for effective prophylaxis, in Johnson FN (ed): Handbook of Lithium Therapy. Baltimore, University Park Press, 1980, pp 243–247.
O’Sullivan K, Whillans P, Daley M, Caroll B, Clare A, Conney J: A comparison of alcoholics with and without effective disorder. Br J Psychiatry 143: 133–138, 1983.
Miller WR, Hester RK: Inpatient alcoholism treatment: Who benefits? Am Psycholo 41: 794–805, 1986.
Kofoed LL: Chemical monitoring of disulfiram compliance: A study of alcoholic outpatients. Alcohol Clin Exp Res 11: 481–485, 1987.
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Clark, D.C., Fawcett, J. (1989). Does Lithium Carbonate Therapy for Alcoholism Deter Relapse Drinking?. In: Galanter, M. (eds) Recent Developments in Alcoholism. Recent Developments in Alcoholism, vol 7. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-1678-5_16
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DOI: https://doi.org/10.1007/978-1-4899-1678-5_16
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