Login Register Cart 0
Generic placeholder image

Current Psychiatry Research and Reviews

Editor-in-Chief

ISSN (Print): 2666-0822
ISSN (Online): 2666-0830

Back
Journal Home About Journal Editorial Board Current Issue Volumes/Issues
Subscribe
Case Report

Lithium-induced Discontinuation Refractoriness: A Report of Two Cases

Author(s): İkbal İnanlı*

Volume 20, Issue 1, 2024

Published on: 23 January, 2023

Page: [70 - 73] Pages: 4

DOI: 10.2174/2666082219666221228123312

Price: $65

Abstract

Introduction: Lithium is an effective mood stabilizer. In patients with bipolar disorder using long-term lithium, discontinuation of lithium can lead to severe clinical outcomes such as lithium-induced discontinuation refractoriness. We present two clinical cases of lithium- induced discontinuation refractoriness.

Case Presentation: We present two female patients with a good long-term response to lithium. Both patients did not have a mood episode for many years and had residual symptoms. The first patient discontinued lithium voluntarily, while the second patient discontinued lithium treatment due to impaired thyroid function. Lithium was added to the treatment of both patients, but lithium-induced discontinuation refractoriness developed.

Conclusion: It should be kept in mind that it may develop refractoriness to lithium when deciding to discontinue lithium treatment, especially in patients with a good long-term response to lithium.

« Previous Next »
Graphical Abstract

[1]
de Vries C, van Bergen A, Regeer EJ, Benthem E, Kupka RW, Boks MPM. The effectiveness of restarted lithium treatment after discontinuation: Reviewing the evidence for discontinuation-induced refractoriness. Bipolar Disord 2013; 15(6): 645-9.
[http://dx.doi.org/10.1111/bdi.12105] [PMID: 23911110]
[2]
Post RM. Acquired lithium resistance revisited: Discontinuation-induced refractoriness versus tolerance. J Affect Disord 2012; 140(1): 6-13.
[http://dx.doi.org/10.1016/j.jad.2011.09.021] [PMID: 22154708]
[3]
Cakir S, Yazıcı O, Post RM. Decreased responsiveness following lithium discontinuation in bipolar disorder: A naturalistic observation study. Psychiatry Res 2017; 247: 305-9.
[http://dx.doi.org/10.1016/j.psychres.2016.11.046] [PMID: 27974284]
[4]
Yazıcı O, Kora K, Polat A, Şaylan M. Controlled lithium discontinuation in bipolar patients with good response to long-term lithium prophylaxis. J Affect Disord 2004; 80(2-3): 269-71.
[http://dx.doi.org/10.1016/S0165-0327(03)00133-2] [PMID: 15207941]
[5]
Suppes T, Baldessarini RJ, Faedda GL, Tondo L, Tohen M. Discontinuation of maintenance treatment in bipolar disorder: Risks and implications. Harv Rev Psychiatry 1993; 1(3): 131-44.
[http://dx.doi.org/10.3109/10673229309017072] [PMID: 9384841]
[6]
Post RM, Leverich GS, Altshuler L, Mikalauskas K. Lithium-discontinuation-induced refractoriness: Preliminary observations. Am J Psychiatry 1992; 149(12): 1727-9.
[http://dx.doi.org/10.1176/ajp.149.12.1727] [PMID: 1443252]
[7]
Okada A. Acute renal failure induced by markedly decreased appetite secondary to a depressive episode after discontinuation of long-term lithium therapy in an elderly patient with bipolar disorder. BMJ Case Rep 2014; 2014: bcr2013203422.
[8]
Appleby B, Wise T, Isaac A. A case of refractoriness to lithium therapy following its discontinuation in a previously responsive patient. Harv Rev Psychiatry 2006; 14(6): 330-2.
[http://dx.doi.org/10.1080/10673220601070039] [PMID: 17162656]
[9]
Wegmann SD, Kessing LV. Recurrence following discontinuation of 28 years of lithium therapy. Ugeskr Laeger 2011; 173(11): 820-1.
[PMID: 21402017]
[10]
Cavanagh J, Smyth R, Goodwin GM. Relapse into mania or depression following lithium discontinuation: A 7-year follow-up. Acta Psychiatr Scand 2004; 109(2): 91-5.
[http://dx.doi.org/10.1046/j.1600-0447.2003.00274.x] [PMID: 14725588]
[11]
Baldessarini RJ, Pinna M, Contu M, Vázquez GH, Tondo L. Risk factors for early recurrence after discontinuing lithium in bipolar disorder. Bipolar Disord 2022; i: 13206.
[http://dx.doi.org/10.1111/bdi.13206] [PMID: 35319801]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy