Lithium in Psychiatry-The Benefits and Risks Associated with the Lithium Salts Treatment in Affective Disorders
Joanna Iskra-Trifunovic, Mateusz Szymczak, Andrzej Jasiewicz, Anna Grzywacz and Jerzy Samochowiec
Affiliation: Department of Psychiatry, Pomeranian Medical University, 26 Broniewskiego, 71-460 Szczecin, Poland.
Keywords: Bipolar disorder, depression, lithium, mania, meta-analysis, suicide.
Lithium treatment history goes far back before it was thoroughly described in the literature which is now
available to us. However, disorders that were initially treated with lithium salts were completely unrelated to psychiatry.
The article “Lithium salts in the treatment of psychotic excitement” from 1949 written by John Cade is considered to be
the introduction of lithium to modern psychiatric therapy and the beginning of modern clinical psychopharmacology.
In the present treatment guidelines for bipolar disorders lithium is recommended as a first-line maintenance therapy. What
is worth mentioning is that the number of indications, including major depressive disorder, for instance, is growing. In
addition, numerous meta-analyses focused on antisuicidal effect of lithium therapy were also performed.
On the basis of the most recent literature available in this paper we presented indications for the preventive use of lithium
for such disorders as mania, bipolar disorder as well as the occurrence of depressive episodes in major depressive
disorder. It is worth pointing out that some studies indicate lithium to be the only medicine proved to be effective for
mood stabilization. Interactions between lithium and other medicines were described in detail. In this paper we also
described and discussed possible side effects of lithium therapy, including renal failure, hypothyroidism,
hyperparathyroidism, weight gain and teratogenicity.
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