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 .
Acute antidepressant effect of lithium is associated with fluctuation of calcium and magnesium in plasma
In a double‐blind study on 22 patients with major depressive disorder the effects of lithium and clomipramine on signs and symptoms and on calcium and magnesium in plasma were compared . Ratings of antidepressant and side effects were performed by 2 psychiatrists at the end of a placebo period of 5–7 days and after treatment for 2 and 4 weeks . Psychopathology was rated by 15 reported and 4 observed items from the Comprehensive Psycho pat ho logical Rating Scale ( CPRS ) . Eleven items present in 72–100 % of the patients were used to evaluate the effect of the two drugs . After 2 weeks of treatment the rated scores dropped for more than half of the CPRS items . After 4 weeks the scores for all but one item were reduced in both groups . The sums of scores were significantly reduced after 2 weeks in both groups and after 4 weeks global scores were reduced as well . The drugs had notable and similar antidepressant effects . Lithium treatment was associated with fluctuations in calcium and magnesium levels in plasma not seen during clomipramine treatment . Serum prolactin increased during clomipramine treatment but was unaffected by lithium treatment . No correlations were found between the sum of rating scores and blood levels of drugs , prolactin , calcium or magnesium
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 .