[Lithium Withdrawal Symptoms - A Systematic Review]. / Entzugssyndrom nach dem Absetzen von Lithium ­ Eine systematische Literaturübersicht.

ABSTRACT

BACKGROUND: Withdrawal symptoms of lithium have not been systematically assessed to date. AIM: Systematic review of withdrawal symptoms after discontinuation of pharmacological treatment with lithium. METHODS: Systematic literature search in PubMed and reference lists of relevant articles. We included clinical trials and case reports. RESULTS: Out of 249 articles, six met our inclusion criteria, entailing six trials and a case series. Four trials and three case reports point to the existence of a withdrawal syndrome after discontinuation of lithium. Occurrence of symptoms was not dependent on the primary disorder for which lithium was initiated. Frequently reported symptoms were irritability, restlessness and somatic symptoms like vertigo, dizziness or lightheadedness. Symptoms occurred within the first week and were generally mild and self-limiting within weeks. CONCLUSION: Current evidence indicates that withdrawal symptoms after discontinuation of lithium can occur. There is a need for controlled studies of high methodological quality in order to assess predictors of and prevention strategies for discontinuation syndromes.