Long-Term Drug Therapy in Affective Disorders

The development of drugs for long-term treatment of the affective disorders depends upon the reconciliation of theoreticians and clinicians. Drug therapy relies upon the acknowledgment of the heterogeneity of depressions, and upon the revival of the disease concept of the affective disorders. Based upon these assumptions, lithium has been used in maintenance therapy. Further controlled studies are needed to conclusively demonstrate the efficacy of lithium in preventing manic episodes. Most difficult problems arise in evaluation studies of lithium in preventing recurrent depressive episodes. Although various research designs have a role in establishing the overall efficacy of lithium, fully controlled doubleblind studies are essential. Only further fully controlled studies can determine more definitely the status of lithium in the treatment of the affective disorders.