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 .
A double-blind comparison of lithium carbonate and maprotiline in the prophylaxis of the affective disorders.
A double-blind prospect i ve study was carried out comparing the prophylactic effect of maprotiline and lithium carbonate over a period of one year in patients suffering from recurrent affective disorders . The average Affective Morbidity Index was lower , but not significantly so , in patients treated with lithium .  A further analysis , based on dividing patients into those with no affective morbidity and those who showed some affective morbidity during the study , demonstrated lithium carbonate to be significantly superior to maprotiline both in the group as a whole and in unipolar depressives . A correlation between high plasma maprotiline concentration and low morbidity was observed and was in line with an earlier report . A highly significant negative correlation ( r=-0 - 97 ; p less than 0 - 001 ) was found between plasma maprotiline concentration and body weight . Although the results showed lithium carbonate to be superior to maprotiline in the study , it should be emphasized that the plasma levels of lithium  were constantly monitored and maintained at what is considered to be its optimum concentration , whereas the maprotiline treated patients were kept on a fixed dosage regime irrespective of plasma levels
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 .