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The therapeutic myth

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The History of Lithium Therapy

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Abstract

In 1967, a young doctor by the name of Barry Blackwell completed his training in both psychiatry and pharmacology at the Maudsley Hospital in London. He was offered, and accepted, a place as a Research Fellow at the Maudsley, and worked for the next year with Professor Michael Shepherd who was then Professor of Epidemiological Psychiatry.1 At that time, the claims for lithium prophylaxis were beginning to be loudly heard, and Blackwell’s interest in the topic was immediately aroused. He and Shepherd examined the data that were available and came to the conclusion that the claims for prophylactic efficacy were simply not supported by the evidence. They presented their argument in an article entitled ‘Prophylactic lithium: another therapeutic myth?’ which was published in the Lancet on 4 May 1968.2

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Notes and references

  1. Blackwell, B. and Shepherd, M. (1968) ‘Prophylactic lithium: another therapeutic myth? An examination of the evidence to date’, Lancet, i, 968–71.

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  2. Baastrup, P. C. and Schou, M. (1967) ‘Lithium as a prophylactic agent. Its effect against recurrent depressions and manic-depressive psychosis’, Archives of General Psychiatry, 16, 162–72.

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  3. Blackwell and Shepherd, ‘Prophylactic lithium: another therapeutic myth?’, 968 (note 2).

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  4. Ibid., 969.

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  5. In the original passage a series of footnote references indicated which patients were being referred to, as identified by the code numbers used by Baastrup and Schou in their article ‘Lithium as a prophylactic agent’ (note 3).

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  6. Blackwell and Shepherd, ‘Prophylactic lithium: another therapeutic myth?’, 969 (note 2).

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  7. Ibid., 970.

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  8. Baastrup, P. C. and Schou, M. (1968) ‘Prophylactic lithium’, Lancet, i, 1419–22.

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  9. Ibid., 1420.

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  10. Ibid.

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  11. Ibid.

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  12. Hullin, R. P., McDonald, R., Anderson, W. McC. and Geraghty, S. M. J. (1968) ‘Prophylactic lithium’, Lancet, i, 1155–56.

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  13. Laurell, B. and Ottosson, J. O. (1968) ‘Prophylactic lithium?’, Lancet, ii, 1245–46.

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  14. Ibid., 1245.

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  15. Ibid.

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  16. Fieve, R. R. and Platman, S. R. (1968) ‘Prophylactic lithium?’, Lancet, i, 830.

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  17. Ibid.

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  18. Ibid.

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  19. Lader, M. H. (1968) ‘Prophylactic lithium’, Lancet, ii, 103.

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  20. Ibid.

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  21. Ibid.

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  22. Baastrup, P. C. and Schou, M. (1968) ‘Prophylactic lithium?’ Lancet, ii, 349–50.

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  23. Sargant, W. (1968) ‘Prophylactic lithium?’ Lancet, ii, 216.

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  24. Kline, N. S. (1968) ‘Lithium comes into its own’, American Journal of Psychiatry, 125, 558–60.

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  25. Ibid., 558.

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  26. Ibid.

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  27. Ibid., 559.

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  28. Blackwell, B. (1969) ‘Need for careful evaluation of lithium’, American Journal of Psychiatry, 125, 1131.

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  29. Kline, N. S. (1969) ‘Dr Kline replies’, American Journal of Psychiatry, 125, 1311.

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  30. Blackwell, B. (1969) ‘Lithium: prophylactic or panacea?’, Medical Counterpoint, November, 52–59.

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  31. Ibid., 52.

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  32. Ibid., 54.

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  33. Ibid., 56.

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  34. Ibid., 52.

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  35. Ibid., 59.

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  36. Shepherd, M. (1970–71) ‘A prophylactic myth’, International Journal of Pychiatry, 9, 423–25.

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  37. Ibid., 425.

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  38. Shull, W. K. and Sapira, J. D. (1970) ‘Critique of studies of lithium salts in the treatment of mania’, American Journal of Psychiatry, 127, 218–22.

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  39. Schou, M. (1974) ‘Ethical problems of therapeutic and prophylactic trials in manic-depressive disorder’. In, Bohaček, N. and Mihovilovič, M. (eds) Psihofarmakologija 3: Proceedings of the 3rd Yugoslav Psychopharmocological Symposium, Opatija, 1973 (Zagreb: Medicinska Naklada) 323–28. Quotation from 325–26.

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  40. Ibid., 326.

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  41. Baastrup, P. C., Poulsen, J. C., Schou, M., Thomsen, K. and Amdisen, A. (1970) ‘Prophylactic lithium: double-blind discontinuation in manic-depressive and recurrent-depressive disorders,’ Lancet, ii, 326–30.

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  42. Blackwell, B. (1970) ‘Lithium’, Lancet, ii, 875.

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  43. Schou, M. (1970) ‘Lithium’, Lancet, ii, 875–76.

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  46. Armitage, P. (1971) ‘Prophylactic lithium’, Lancet, i, 1066;

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  47. Mantel, N. (1971) ‘Sequential methods in clinical trials’, Lancet, i, 1182–83.

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  48. Blackwell, B. (1972) ‘Prophylactic lithium: science or science fiction?’, American Heart Journal, 83, 139–41.

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  49. Ibid., 140.

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  50. Shepherd, M. (1974) ‘Discussion’. In, Bohaček and Mihovilovič, M. (eds) Psihofarmakologija 3: Proceedings of the 3rd Yugoslav Psychopharmacological Symposium, Opatija, 1973 (Zagreb: Medicinska Noklada) 329–30. Quotation from 329.

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  51. Ibid., 330.

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  52. Baastrup and Schou, ‘Prophylactic lithium’ (note 9).

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  53. Blackwell and Shepherd, ‘Prophylactic lithium: another therapeutic myth?’ (note 2).

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  54. Schou, M. (1974) ‘Discussion’. In, Bohaček, N. and Mihovilovič, M. (eds) Psihofarmakologija 3: Proceedings of the 3rd Yugoslav Psychopharmacological Symposium, Opatija, 1973 (Zagreb: Medicinska Noklada) 330–32. Quotation from 331.

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  55. Schou, M., Thomsen, K. and Baastrup, P. C. (1970) ‘Studies on the course of recurrent endogenous affective disorders’, International Pharrnacopsychiatry, 5, 100–06.

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  56. The error appears in line 11 of the left-hand column on page 328 of Baastrup et al., ‘Prophylactic lithium: double-blind discontinuation in manic-depressive and recurrent-depressive disorders’ (note 47).

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  57. Schou, M. and Strömgren, E. (eds) (1979) Origin, Prevention and Treatment of Affective Disorders (London: Academic Press).

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  58. Medical Research Council Drug Trials Subcommittee (1981) ‘Continuation therapy with lithium and amitriptyline in unipolar depressive illness: a controlled trial’, Psychological Medicine, 11, 409–16.

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  59. The principles of prophylactic trials which had been so well worked out by Jules Angst and Paul Grof were subsequently presented in a form applicable to trials of all substances which have a suspected prophylactic effect: Grof, P., Schou, M., Angst, J., Baastrup, P. C. and Weis, P. (1970) ‘Methodological problems of prophylactic trials in recurrent affective disorders’, British Journal of Psychiatry, 116, 599–619.

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  60. Schou, M. (1973) ‘Prophylactic lithium maintenance treatment in recurrent endogenous affective disorders’. In, Gershon, S. and Shopsin, B. (eds) Lithium: Its Role in Psychiatric Research and Treatment (New York: Plenum) 269–94. Quotation from 286–87.

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Authors and Affiliations

  1. Department of Psychology, University of Lancaster, UK

    F. Neil Johnson

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  1. F. Neil Johnson
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© 1984 F. Neil Johnson

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Johnson, F.N. (1984). The therapeutic myth. In: The History of Lithium Therapy. Palgrave Macmillan, London. https://doi.org/10.1007/978-1-349-07289-7_7

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  • DOI: https://doi.org/10.1007/978-1-349-07289-7_7

  • Publisher Name: Palgrave Macmillan, London

  • Print ISBN: 978-1-349-07291-0

  • Online ISBN: 978-1-349-07289-7

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