A lithium clinic for bipolar patients: 2-year outcome of the first 148 patients

Objective: This paper describes the outcome for the first 148 patients referred to a lithium clinic. Method: Two-year follow-up data from treatment charts are reported for all patients entering a lithium clinic in the study period. Results: Lithium was given as the only mood stabilizer in 132 (89.2%) of the cases. Thirty-two (21.6%,) patients were readmitted with a new affective disorder episode. Twenty-nine (19.6%) patients discontinued treatment prematurely. Variables predicting the recurrence of new affective disorder episodes as well as premature discontinuation of treatment were identified. Conclusion: The majority of bipolar patients received lithium for prophylaxis against recurrent affective disorder episodes. The outcome was moderate but comparable to the 30-40%, improvement usually reported in follow-up studies of bipolar patients given long-term prophylactic treatment with lithium. Better long-term treatment results for bipolar patients depend on both the development of more effective mood stabilizing drugs or drug combinations and the improvement of patients' adherence to treatment.