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 .
Prophylactic lithium: double blind discontinuation in manic-depressive and recurrent-depressive disorders.
Abstract Fifty manic-depressive patients and thirty-four patients with recurrent endogenous depression who had been on open lithium treatment for at least a year took part in double-blind discontinuance studies to compare lithium carbonate and placebo . Within each diagnostic group matched pairs were allocated at r and om to lithium carbonate or placebo .  Relapses occurring first in the lithium partners constituted placebo preferences and those occurring first in the placebo parners lithium preferences . Relapses were recorded when requiring hospital admission or supervision with additional therapy at home . Serum-lithium levels were monitored . The trials terminated in significant preference for lithium both in manic-depressive and in recurrent-depressive disorder ; this happened when nine patients in each group had relapsed on placebo and none on lithium . During the whole trial , which lasted five months , twenty-one placebo patients relapsed and none of the lithium patients . Before the trials , patients had been on lithium for up to 7 years ; even after this long period there was still risk of relapse on withdrawal of the drug
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 .