Nicolas Schaad

Lithium Discontinuation and Reintroduction

Stopping medication in patients who are lithium responders is associated with a high risk of early recurrence of bipolar illness, especially mania, in the following months. A shorter time to recurrence has been shown after rapid versus slow discontinuation. A loss of the preventive effect of lithium on suicidal risk has also been shown after lithium discontinuation. Possible refractoriness to treatment was described more than 20 years ago following lithium discontinuation; however, available data do not provide convincing evidence that lithium is less effective when it is reintroduced after treatment discontinuation.