Abstract

LITHIUM SNUBBED, YET STILL VALUABLE: REVIEW OF ITS CLINICAL USE IN PSYCHIATRY

Hani Raoul Khouzam MD, MPH*, Avak A. Howsepian, MD, PhD John Tran MD, DFAPA and Jacob J. Mathew PhD

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Abstract

The availability of several antiepileptic drugs and atypical antipsychotic agents for the management of bipolar disorders has almost rendered the use of lithium salts (hereafter, ‘lithium’) obsolete in the armamentarium of many 21st century clinicians. The purpose of this review is to summarize lithium’s history, its mechanism of action, its interaction with other medications, its dosage, its administration, and the monitoring of its serum blood level. The valuable clinical role of lithium as a mood stabilizer for the treatment of acute bipolar mania, bipolar depression, and for the prevention of mood episodes associated with bipolar disorders is reasserted. Lithium’s effectiveness as an augmenting agent in treatment-resistant unipolar major depressive disorder, its role in reducing the risk of suicide in patients with mood disorders and its neuroprotective effects on improving the prognosis of cognitive disorders is also summarized.

Keywords: Lithium, Depression, Mania, Psychopharmacology, Suicide.