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  • Title: [Risk of inducing resistance upon stopping and restarting lithium after long-term usage].
    Author: Oostervink F, Nolen WA, Hoenderboom AC, Kupka RW.
    Journal: Ned Tijdschr Geneeskd; 2000 Feb 26; 144(9):401-4. PubMed ID: 10719540.
    Abstract:
    Three man, aged 66, 60 and 26 years with bipolar disorder and long periods (20-5 years) of effective lithium prophylaxis had relapses on lithium discontinuation. Once the drug was reinstituted, it was no longer effective. Combinations of lithium with a classical MAO inhibitor or a second mood stabilizer (valproic acid and carbamazepine, respectively) ultimately proved to be successful. The risk of refractoriness should be kept in mind before considering to stop lithium therapy. A better compliance can be achieved by informing patients about the risks of discontinuing lithium, by maintaining a minimal maintenance dose and by adequately coping with possible side effects.
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