LITHIUM RX OF CHILDHOOD MANIC-DEPRESSIVE DISEASE ANP ANTISOCIAL BEHAVIOR DISORDERS

Abstract

Eight children (ages 5-15) with serious behavior disorders responded to lithium carbonate (Li) Rx with dramatic improvement. Aggressive hostile antisocial behavior, and hyperactivity and distractibility, were common to all. All had various Rx over years, including stimulants, tranquilizers, psychotherapy and environmental modification without satisfactory improvement. All were in stable homes (3 adoptive). One group (6 pts.) had cyclic behavior; 5 had family hx. consistent with manic-depressive disease (M-D); 4 met criteria for both mania and depression in childhood (Weinberg & Brumback, Am.J.Dis.Ch. 130:380, 1976). Five had disturbances of vegetative or homeostatic functions (hyperphagia, hyperdipsia, excess sweating, salt craving, sleep disorder, etc.) which improved during Li Rx. Work-up for other causes was negative. The second group (2 pts.) had no cyclic changes, no manic behavior, no vegetative disturbances, and no clear family history of affective disorder. In these, Li was synergistic with stimulants. Li serum levels were maintained in accepted range (0.4-1.0 mEq/L.); no toxicity was seen. Improvement, assessed from function in daily environment, has been maintained 7-25 months (ave. 15 mos.). In 6, Li was discontinued with reversion to previous behavior, which improved after restarting Li. Li Rx produces marked and sustained normalization of behavior in some children with severe disorders of mood and affect. It may help elucidate the relationships between childhood behavior disorders & familial psychiatric disease, esp. M-D and affective disorders.

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