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Lithium in Acute and Maintenance Treatment of Bipolar Disorders

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The Science and Practice of Lithium Therapy

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Abstract

Following the first efficacy trial of lithium prophylaxis in recurrent mood disorders in 1967, lithium has been considered the gold standard for bipolar disorders. However, its use has declined over time as newer drugs have been identified as mood stabilizers. This chapter offers a selective review of studies, focusing on the usefulness of lithium in acute episodes of bipolar disorders and in maintenance treatment. The efficacy of lithium in acute episodes and as a prophylactic treatment has been tested against various antipsychotics in comparative, high-quality clinical trials. These clinical trials demonstrate the efficacy of lithium and confirm that it should still be considered as a major mood stabilizer. We then consider the prevalence of partial or non-adherence with lithium and the reasons why individuals might stop taking a potentially beneficial treatment. The chapter highlights that adherence can be predicted by considering patients’ beliefs about health and exploring their views about the necessity for treatment versus their concerns about medication. We offer a framework for intervention that is more reliable and valid than previous, overly simplistic, predictor models that failed to take into account dynamic changes in adherence over time within and between individuals.

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Author information

Authors and Affiliations

  1. Université Paris-Est, UMR_S955, UPEC, 94000, Créteil, France

    Chantal Henry

  2. Inserm U955, Translational Psychiatry Laboratory – Team 15, 94000, Créteil, France

    Chantal Henry

  3. AP-HP, Hôpital H. Mondor – A. Chenevier, Pôle de psychiatrie, 94000, Créteil, France

    Chantal Henry

  4. Hôpital A. Chenevier, Pavillon Hartmann, Pôle de psychiatrie, 40, rue de Mesly, 94000, Créteil, France

    Chantal Henry

  5. Institut Pasteur, Unité Perception et Mémoire, F-75015, Paris, France

    Aroldo A. Dargél

  6. Academic Psychiatry, Institute of Neuroscience, Newcastle University, England, NE6 4Bf, UK

    Jan Scott

  7. Centre for Affective Disorders, Institute of Psychiatry, London, UK

    Jan Scott

Authors
  1. Chantal Henry
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  2. Aroldo A. Dargél
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  3. Jan Scott
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Corresponding author

Correspondence to Chantal Henry .

Editor information

Editors and Affiliations

  1. Academic Department of Psychiatry, Sydney Medical School The University of Sydney, Sydney, Australia

    Gin S. Malhi

  2. Nightingale Hospitals Paris-Clinique du Château de Garches, Consultant Service Hospitalo-Universitaire Centre Hospitalier Sainte-Anne, Paris, France

    Marc Masson

  3. Publique – Hôpitaux de Paris, INSERM UMR-S1144 Paris-Diderot University, Paris, France

    Frank Bellivier

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Henry, C., Dargél, A.A., Scott, J. (2017). Lithium in Acute and Maintenance Treatment of Bipolar Disorders. In: Malhi, G., Masson, M., Bellivier, F. (eds) The Science and Practice of Lithium Therapy. Springer, Cham. https://doi.org/10.1007/978-3-319-45923-3_12

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  • DOI: https://doi.org/10.1007/978-3-319-45923-3_12

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-45921-9

  • Online ISBN: 978-3-319-45923-3

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