Predictors of Response to Lithium in Patients With Psychoses

Schexnayder, Lisa W. MD
Hirschowitz, Jack MD
Sautter, Fred J. PhD
Garver, David L. MD

Presented at the Young Investigator Poster Section of the 146th annual meeting of the American Psychiatric Association, San Francisco, May 22-27, 1993. Received Dec. 21, 1993; revisions received Aug. 22, 1994, and Jan. 23 and May 1, 1995; accepted June 7, 1995. From the Department of Psychiatry, University of Texas Southwestern Medical Center and the Dallas VA Medical Center, Dallas; and the University of Cincinnati College of Medicine. Address reprint requests to Dr. Garver, University of Texas Southwestern Medical Center, Dallas VA Medical Center (116A), 4500 South Lancaster Ave., Dallas, TX 75216.
Supported in part by NIMH grant MH-42666 and a VA Merit Review grant to Dr. Garver and by a grant from the John Schermerhorn Psychiatric Fund, Southwestern Medical Center.

American Journal of Psychiatry 152(10):p 1511-1513, October 1995.

Objective

This study sought to characterize a subset of patients with DSM-III schizophrenia or schizophreniform disorder who respond to lithium. Method: Sixty-six psychotic patients were given a systematic therapeutic trial of lithium alone. Differences in demographic characteristics, symptoms, and family history of psychotic disorders between the responders and nonresponders to lithium were explored. Results: Responders and nonresponders did not differ significantly in age, duration of illness, length of current episode, distribution of RDC and DSM-III diagnoses, or number of positive symptoms. However, the responders to lithium (N equals 10) exhibited a paucity of negative symptoms and an absence of familial schizophrenic spectrum disorders. Conclusions: These preliminary results suggest the possibility of pretreatment identification of psychotic patients for whom neuroleptic medication could be avoided by therapeutic intervention with lithium alone.

(Am J Psychiatry 1995; 152:1511-1513)