Prophylaxis of affective disorders. Current status of knowledge.

A review of all properly controlled studies clearly indicates that lithium carbonate is prophylactic for mania in bipolar patients; it is suggestive of prophylaxis for depression in both bipolar and unipolar patients. Studies are outlined that would clarify lithium carbonate's prophylactic effect for depression in these two patient groups. Continuation therapy with antidepressants reduces incidences of recurrence in unipolar depressives.

A study of abrupt lithium withdrawal.

Twelve patients were abruptly switched from lithium to placebo as part of a double-blind cross-over study. In contrast to other drugs effective in mood disorders, lithium produced no withdrawal syndrome.

Very high dosage vs standard dosage fluphenazine in schizophrenia. A double-blind study of nonchronic treatment-refractory patients.

Previous work with chronic schizophrenic patients and a pilot study with nonchronic treatment-refractory schizophrenic patients indicated that very high doses of fluphenazine hydrochloride (1,200 mg/day) have a greater antipsychotic effect than do standard doses. Increased side-effects were not reported. In a double-blind six-week random assignment study, 18 nonchronic treatment-refractory patients received the very high dose and 13 the standard dose.

Atypical signs of relapse in affective disorders.

The authors have observed that patients with previous well documented evidence of affective illness can have an atypical relapse of depression precipitated by environmental or interpersonal stress. These patients present with complaints centered around problems resulting from current life stress. They deny sad mood and resist the idea that they are having recurrence of depression.