| | What Doctors Don't Tell You: Lithium evidence `misinterpreted'; Varicose veins: no clot risk | |
Psychiatrists are beginning to question the use of the drug lithium in treating manic-depressives. The drug had passed clinical trials with flying colours and has been in frequent use since the 1960s. But the drug's usage has been reappraised as part of the new wave of evidence-based medicine (!) currently sweeping through the profession. Researchers are now suggesting that the early trials may have been misinterpreted. Suspicions were raised because admission rates for acute cases have not altered despite the use of the drug. The apparent protection given by lithium against relapse might be explained by the fact that stopping lithium could bring on the relapse in the first place (Br J Psychiatry 1995; 167: 569-74).
The widely-held belief that varicose veins increase the risk of developing deep vein thrombosis may well be wrong. And women with varicose veins who take the contraceptive pill or hormone replacement therapy are not as likely to suffer spontaneous thrombosis as had been feared. Several reports have appeared in the past few months which question these beliefs, and cast doubt on the need for surgery on the veins. Women with varicose veins are at greater risk of thrombosis only if they are having major abdominal or pelvic surgery; otherwise, the risk is no greater than for other women (BMJ, January 27, 1996).