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 .
Mianserin and lithium in the prophylaxis of depression.
Forty-one out- patients with a history of at least three attacks of depressive illness were r and omly allocated to treatment on a double-blind basis for one year with either mianserin 20 mg three times daily plus placebo lithium tablets , or to lithium tablets once daily plus placebo mianserin tablets . After one year , the dosage of mianserin was increased to 30 mg t.d.s . for a further six months . All but three of the patients had previously been stabilized on prophylactic lithium therapy . Lithium was found to be significantly superior to mianserin in avoiding admission to hospital or ECT . The overall affective morbidity index , calculated from global rating , showed no significant difference between drugs , but the index of the mianserin group was higher in the second six months than in the first . The lithium group showed no such change .  Lithium remains the choice for the prophylaxis of unipolar recurrent depressive illness
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 .