Abstract: Objective: Cardiovascular side effects of lithium have been reported to occur mainly at higher-than-therapeutic serum levels. We aimed to investigate the impact of the long-term lithium use on electrocardiogram (ECG) parameters in association with the serum levels in patients with bipolar disorder (BD) and in healthy controls (HCs) serving as the reference group.Methods: The study sample consisted of 53 euthymic BD type I patients on lithium monotherapy at therapeutic serum levels (M=0.76, S.D.=0.14, range=0.41–1.09 mmol/l) for at least 12 months and 45 HCs.

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About 50%–60% of patients with depression fail to completely recover on an antidepressant medication according to the Sequenced Treatment Alternatives to Relieve Depression study . Combination therapy, which involves addition of an antidepressant agent with a different chemical profile to the therapeutic regimen, forms an important treatment strategy . However, combination treatment is usually found to be associated with greater side effects

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