2019, Vol. 1, Issue 1, Part A

History: It is an element. It gets its name from “lithos,” the Greek word for stone, because it is present in trace amounts in virtually all rocks. Lithium works with other elements, drugs, enzymes, hormones, vitamins, and growth factors in the body in many different ways. John Cade introduced lithium carbonate for the treatment of mania in 1949, opening the era of modern clinical psychopharmacology. Lithium remains the most extensively studied mood-stabilizing agent. It has had a revolutionary impact in supporting bipolar manic-depressive disorder as a discrete diagnosis, and on psychiatric therapeutics.

Methods: We survey the development of lithium treatment in psychiatry, including findings concerning effects on suicide.

Results: Lithium is the most extensively studied treatment for bipolar disorder and the prototypical mood-stabilizing agent, despite emergence of anticonvulsants and modern antipsychotics. In addition to limiting recurrences of mania, and some reduction of recurrences of bipolar depression, lithium has demonstrated protective effects against suicide. All treatments for bipolar disorder have notable limitations, including sometimes serious Adverse effects includes hypothyroidism, Pregnancy and breast feeding side effects such as birth defects, dehydration incomplete prevention of recurrences of mania and limited prevention of depression, which accounts for the approximately 55% time-ill in long-term follow-up with standard treatments. Lithium can be toxic in untreated overdoses; safe dosing requires monitoring of serum concentrations. Lithium also may have mild teratogenic effects, but far less than those of anticonvulsants used for bipolar disorder.

Conclusions: Lithium opened the era of modern psychopharmacology and continues as the best-established mood-stabilizing treatment for bipolar disorder as well as having strong evidence of suicide-preventing effects. Uses of lithium, First effective treatment for acute mania, Prime example of the value of serendipity, First selective treatment for mania versus psychotic disorders, Encouraged broad acceptance of the concept of bipolar disorder, - First effective treatment for acute mania, Prime example of the value of serendipity, selective treatment for mania versus psychotic disorders, Encouraged broad acceptance of the concept of bipolar disorder Opened the era of modern psychopharmacology, since 1950First treatment with long-term prophylactic efficacy in any major psychiatric disorder, first treatment with substantial evidence of suicide-preventing effects, first psychiatric treatment with clinically useful drug monitoring by serum assays. First selective treatment for mania versus psychotic disorders.