Lithium-induced discontinuation refractoriness: a report of two cases

Lithium is an effective mood stabilizer. In patients with bipolar disorder using long-term lithium, discontinuation of lithium can lead to severe clinical outcomes such as lithium-induced discontinuation refractoriness. We present two clinical cases of lithium-induced discontinuation refractoriness. We present two female patients with a good long-term response to lithium. Both patients did not have a mood episode for many years and had residual symptoms. The first patient discontinued lithium voluntarily, while the second patient discontinued lithium treatment due to impaired thyroid function. Lithium was added to the treatment of both patients, but lithium-induced discontinuation refractoriness developed. It should be kept in mind that it may develop refractoriness to lithium when deciding to discontinue lithium treatment, especially in patients with a good long-term response to lithium.