There were no other statistically significant differences between lithium and antidepressants according to all other outcomes considered .
AUTHORS ' CONCLUSIONS There was adequate efficacy evidence for lithium or antidepressants preventing relapse in unipolar affective disorder , however their relative efficacy was unknown .
BACKGROUND The main rationale for the use of lithium in the long-term treatment of unipolar affective disorder is its efficacy in treating bipolar affective disorder and resistant depression .
However , there is considerable uncertainty about which pharmacological intervention is most effective in the long-term treatment of recurrent unipolar affective disorder .
OBJECTIVES To assess the effects of lithium versus antidepressants for the long-term treatment of recurrent affective disorder .
Comparative efficacy of lithium and amitriptyline in the maintenance treatment of recurrent unipolar depression: a randomised study.
The present study , including 81 depressive patients , compares the prophylactic efficacy of lithium and amitriptyline in recurrent unipolar depression over a treatment period of 2.5 years in a r and omised multicentre design .  Hospitalisation , re-emergence of depressive or subdepressive recurrences , unwanted side-effects and need of concomitant psychotropic medication were considered to indicate treatment failures . Average dosage for amitriptyline  was 98 + /- 37 mg/day , average  lithium blood level was 0.59 + /- 0.12 mmol/l . Survival analyses demonstrated a significant superiority of lithium ( P = 0.015 ) regarding the outcome criteria ' recurrences and /or sub clinical recurrences ' and non-significantly better results of lithium compared to amitriptyline concerning ' recurrence ' ( P = 0.059 ) or ' recurrence and /or concomitant medication ' ( P = 0.066 )
There were no other statistically significant differences between lithium and antidepressants according to all other outcomes considered .
AUTHORS ' CONCLUSIONS There was adequate efficacy evidence for lithium or antidepressants preventing relapse in unipolar affective disorder , however their relative efficacy was unknown .
BACKGROUND The main rationale for the use of lithium in the long-term treatment of unipolar affective disorder is its efficacy in treating bipolar affective disorder and resistant depression .
However , there is considerable uncertainty about which pharmacological intervention is most effective in the long-term treatment of recurrent unipolar affective disorder .
OBJECTIVES To assess the effects of lithium versus antidepressants for the long-term treatment of recurrent affective disorder .