Lithium Combinations in Acute and Maintenance Treatment of Unipolar and Bipolar Depression

Bipolar illness and unipolar depression are both affective disorders associated with high lifetimemorbidity and premature mortality due to suicide. Numerous double-blind, placebo-controlled trialshave shown that lithium augmentation therapy is effective in treating acute episodes of bipolar depression, refractory major depression, and delusional depression as well as in reducing recurrences ofthese illnesses. Lithium is the only agent approved by the U.S. Food and Drug Administration formaintenance treatment of bipolar disorder. Further research is needed to specifically address whetherthe antidepressant effect of adding lithium is greater in bipolar disorder or in unipolar depressions.This article will summarize available evidence and clinical considerations regarding the use of lithiumaugmentation in acute and maintenance treatment of unipolar and bipolar depressions.

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