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Review: lithium augmentation increases treatment response in refractory depression

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 QUESTION: In patients with refractory depression, is lithium augmentation clinically effective?

Data sources

Studies were identified by searching Medline (1980 to June 1997) and the Cochrane Library and by scanning the references of published reviews and standard textbooks.

Study selection

Studies were selected if they were double blind, placebo controlled trials that involved patients who had not responded to conventional antidepressants; accepted, operationalised diagnostic criteria for depression were used; and outcome measures included acceptable criteria for assessing response.

Data extraction

2 reviewers independently assessed the quality of each study (Quality Assessment Scale by Detsky) and resolved differences by consensus. Data were extracted on study population, antidepressant treatment, lithium dose, treatment duration, response criteria, and treatment response.

Main results

9 randomised controlled trials (RCTs) involving 234 patients met the inclusion …

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  • Source of funding: no external funding.

  • For correspondence: Dr M Bauer, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, 300 UCLA Medical Plaza, Suite 2330, Los Angeles, CA 90095-6968, USA. Fax +1 310 206 4310.

  • * p values calculated from data in article and data supplied by author.