Research paper
After lithium augmentation: a retrospective follow-up of patients with antidepressant-refractory depression

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Abstract

There have been no systematic follow-up studies of depressed patients with documented refractoriness to antidepressants treated with lithium augmentation. To assess their longitudinal course, 66 (88%) of an original cohort of 75 such patients were followed in a retrospective, naturalistic design for 29.0 ± SD 15.3 months. At follow-up, 29% had poor, 23% fair, and 48% good outcomes. An acute marked positive response to lithium augmentation predicted a good subsequent course. Acute partial and non-responders had a less benign outcome despite subsequent treatments. These findings indicate that outcomes of patients with documented refractory depression are heterogenous. There is a suggestion that an acute marked response to lithium augmentation is sustained regardless of the duration of taking lithium, but this must be regarded as speculative.

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    Present address: Harvard University Medical School, McLean Hospital, 115 Mill Street, Belmont, MA 02178, U.S.A.

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    Reprint requests to: Lawrence H. Price, M.D., 34 Park Street, New Haven, CT 06508, U.S.A.

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