Handbook of Lithium Therapy

pp 143-149

Lithium Non-Responders and their Treatment

  • Athanasio Kukopulos
  • , Leonardo Tondo

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Since the first trials of lithium as a prophylactic treatment against manic-depressive recurrences1, it has been clear that a certain number of patients do not show substantial improvement under continuous lithium treatment. This does not lessen the value of the prophylactic efficacy of lithium, because a much larger number of patients improve enormously under this treatment. The patients that respond poorly to lithium are nevertheless a serious problem, since their form of the disease is among the severest and they are most in need of an effective prophylaxis. As a great many lithium non-responders have very frequent recurrences, other treatments that act only upon a single episode are almost useless, because after having been treated for one episode, the patients are shortly sick again in a new episode. For these patients a lithium prophylaxis failure is a bitter disappointment, and it leaves the physician without alternatives.