Lithium As a Prophylactic Agent

THE SPECIFIC therapeutic effect of lithium in manic phases of the manicdepressive psychosis was first observed in 19491and was confirmed later in controlled studies,2,3as well as in a number of uncontrolled ones. A prophylactic action of the drug against both the manic and depressive phases of the illness could be noted in a few of the patients described by Schou et al.2More systematic and detailed observations of this effect were made independently by Hartigan4and Baastrup,5and the termnormothymoticswas proposed for drugs with a specific action against manic-depressive psychosis.6 In order to demonstrate prophylactic drug action in a disorder such as manicdepressive psychosis, which is characterized by a capricious and largely unpredictable course, one must study a large number of patients who have a sufficiently high risk of relapse and who are observed for