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Does lithium prevent hospitalizations? Or if lithium is stopped, what happens to admission rates? You might be surprised to see how few data were available demonstrating an effect of lithium in the prevention of relapse––it was debated, in fact, until the early 2000s. In children, a randomized trial of lithium discontinuation was published in 2019 with a sample size of 31. There is a dearth of research on this despite how commonly we use lithium and think of it as a tool for preventing relapse in bipolar disorder.
To help address the question of how hard you should work on keeping lithium tolerable, let’s have a look at a recent paper from Sweden. Dr. Louise Öhlund and colleagues created what they called the LiSIE cohort––this included 467 patients who stopped lithium at some point over a 14-year retrospective study period. In this paper, the authors present what they call a
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