Lithium for schizophrenia


The evidence base for the use of lithium in schizophrenia is limited to 22 studies of overall low methodological quality. There is no randomised trial-based evidence that lithium on its own is an effective treatment for people with schizophrenia. There is some GRADE low quality evidence that augmentation of antipsychotics with lithium is effective, but the effects are not significant when more prone-to-bias open RCTs are excluded. Nevertheless, further large and well-designed trials are justified. These should concentrate on two target groups: (1) people with no affective symptoms, so that trialists can determine whether lithium has an effect on the core symptoms of schizophrenia, and (2) people with schizoaffective disorders for whom lithium is widely used in clinical practice, although there is no evidence to support this use.

In late 1982 due to a temporary change of psychiatrist I was taken of antipsychotics and put on lithium. My diagnosis was in the process of changing from schizophrenia to schizoaffective.
Soon after starting lithium(4 months) I left hospital. Expectations were I’d be back within 6 weeks(I never have been). I was on lithium for 20 years despite not achieving recovery they were probably the best years of my life mentally. This despite the first 7 years not having a stable place to live.
How much was due to lithium (often levels were below so called therapeutic levels) and how much it coincided with having a supportive partner is anyone’s guess.
Towards the end I was not doing as well mentally . Meds can lose effectiveness over time.
I think the time they put me on lithium was the time when psychiatry first really tried to see if lithium was a good med for schizophrenia like illnesses especially those with a significant affective component.