He found that 48% had a relapse requiring hospitalisation over an average follow-up duration of 3.2 years.
So there is nothing magic or specific about lithium’s action in manic depression.
A large study conducted in the 1970s, however, found that rates of hospital admission for relapse were 21.5% per year in the lithium group.
Several ‘naturalistic’ studies have tracked the progress of people taking lithium and other treatments.
The possibility that relapses in the placebo groups in these trials are induced by withdrawal of previous medication would make sense of the fact that it has proved impossible to demonstrate that people receiving modern drug treatment for manic depression do any better than those who don’t, or didn’t. Two important studies have examined rates of relapse in people with classical manic depressive symptoms prior to the 1950s.
American psychiatrist George Winokur found the records of 100 patients admitted to a psychiatric hospital between 19 with an episode of mania and then followed them up through their hospital records.