Lithium combinations in acute and maintenance treatment of unipolar and bipolar depression.

Bipolar illness and unipolar depression are both affective disorders associated with high lifetime morbidity and premature mortality due to suicide. Numerous double-blind, placebo-controlled trials have shown that lithium augmentation therapy is effective in treating acute episodes of bipolar depression, refractory major depression, and delusional depression as well as in reducing recurrences of these illnesses. Lithium is the only agent approved by the U.S. Food and Drug Administration for maintenance treatment of bipolar disorder. Further research is needed to specifically address whether the antidepressant effect of adding lithium is greater in bipolar disorder or in unipolar depressions. This article will summarize available evidence and clinical considerations regarding the use of lithium augmentation in acute and maintenance treatment of unipolar and bipolar depressions.