Lithium: The Forgotten Wonderdrug

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Relapse in Bipolar Disorder • Manic episodes occur more than once in 90% of patients • Many patients continue to experience subthreshold symptoms even after recovery from a full mood episode Goodwin FK. Rationale for long-term treatment of bipolar disorder and evidence for long term lithium treatment. J Clin Psychiatry. 2002;63 Suppl 10:5-12.
Relapse in Bipolar Disorder • Despite continual maintenance treatment, there is evidence that 5-year risk of relapse into mania or depression of 73% • Of those who relapsed, two-thirds had multiple relapses Gitlin MJ, Swendsen J, Heller TL, Hammen C. Relapse and impairment in bipolar disorder. Am J Psychiatry. 1995;152:1635-1640.
Page 1 and 2: Lithium: The Forgotten Wonderdrug W
Page 3: What Is Lithium
Page 7 and 8: History • 1880s to early 1900s li
Page 9 and 10: Psychiatric Uses For Lithium • An
Page 11 and 12: Advantages of Lithium • Well esta
Page 13 and 14: Decline In Lithium Use
Page 15 and 16: Trend in Veterans Affairs Medical C
Page 17 and 18: Lithium Therapy And Suicide Risk In
Page 19 and 20: Suicide Risk in Mood Disorders •
Page 21 and 22: Overall Rates • Suicides and atte
Page 23 and 24: Rates of Suicide Attempts • Suici
Page 25 and 26: Risk Reduction in Diagnostic Subtyp
Page 27 and 28: Other Important Risk Factors in Sui
Page 29 and 30: Limitations of Evidence • Lack of
Page 31: Rationale For Long Term Treatment W
Page 35 and 36: Episode Recurrence in Bipolar I Dis
Page 37 and 38: Episode Recurrence in Bipolar I Dis
Page 39 and 40: Reduction of Episode Recurrence •
Page 41 and 42: Risk vs Benefit Of Lithium Maintena
Page 43 and 44: Potential Toxicity of Long Term Lit
Page 45 and 46: Reducing Risk, Increasing Benefit:
Page 47 and 48: Initiating and Monitoring Lithium T
Page 49 and 50: Initiating Lithium • Prior to ini
Page 51 and 52: Blood Monitoring • Lithium can be
Page 53 and 54: Therapeutic Levels • Upper end: 1
Page 55 and 56: Lithium Discontinuation
Page 57 and 58: Reduced Morbidity After Gradual Dis
Page 59 and 60: Lithium Discontinuation and Subsequ
Page 61 and 62: APA Treatment Guidelines For Bipola
Page 63 and 64: Bipolar Depression • First line t
Page 65 and 66: Maintenance “The medications with

Lithium: The Forgotten Wonderdrug

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