Schou M
Psychopathology. 1986;19 Suppl 2:201-6. doi: 10.1159/000285155.
Lowering of standard serum lithium levels to 0.5-0.8 mmol/l has led to a marked reduction of side effects. Safety is increased through temporary discontinuation or dosage reduction of lithium in special risk situations. In unipolar but not in bipolar patients maintenance treatment with antidepressants is a valid alternative to lithium, and treatment choice may be determined by individual tolerance. Carbamazepine and valproate are worth trying in bipolar patients not responding to or not tolerating lithium. General principles for long-term preventive therapy are discussed.
将标准血清锂水平降至0.5 - 0.8 mmol/l已使副作用显著减少。在特殊风险情况下，通过暂时停用锂或减少锂剂量可提高安全性。在单相情感障碍患者而非双相情感障碍患者中，用抗抑郁药进行维持治疗是锂治疗的有效替代方案，治疗选择可由个体耐受性决定。对于对锂无反应或不耐受的双相情感障碍患者，卡马西平和丙戊酸盐值得一试。文中讨论了长期预防性治疗的一般原则。
