The effect of lithium carbonate on alcoholism in 20 male patients with concurrent major affective disorder.
Descriptively, Alcoholism and Bipolar Affective Disorders may resemble each other. Both disorders are marked by a chronic course with periods of remission and relapse and often profound affective disturbance. Since lithium carbonate has shown a remarkable efficacy in the treatment or prophylaxis of Bipolar Affective Disorder, it would be natural to hope for some similar dramatic benefit in alcoholism. Two controlled studies have been published in English in which lithium salts showed some benefits on drinking in "depressed" patients with alcoholism. Other studies published in the literature have been less certain but cautiously positive about some anti-alcohol effects of lithium. Favorable anecdotal reports have continued to appear, and there is every indication that lithium may be prescribed quite widely in alcoholism. It is remarkable that since lithium has a very specific therapeutic effect on mania and a much less clear effect on depression that no one has previously reported on manic (or Bipolar) patients with problem drinking or alcoholism in a systematic fashion. This lack of data may perhaps result from difficulty in locating such a population. In a previous publication, two of the present authors reported little benefit on alcohol symptoms in a small number of patients with mania who they treated for 6 or more months. In the present study, we have extended this first report to a group of 20 Bipolar or manic patients with concurrent diagnosis of alcoholism or abusive drinking, all of whom were followed on lithium for not less than one year.