Lithium: The Forgotten Wonderdrug

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Not Everyone Responds to Lithium Maintenance • Rapid Cycling – Rapid cycling reduces efficacy of maintenance therapy with lithium • Amount of time with bipolar disorder before lithium maintenance initiation – The less time the greater the benefit • Lithium responders tend to present with episodic, fully remitting course and with euphoric rather than dysphoric mania
Reducing Risk, Increasing Benefit: Rationale for Using Lithium in Combination With Other Mood Stabilizers • Results from comparison of lamotrigine and lithium suggest that the two have complementary actions – Lithium has a greater effect on recurrence of mania in maintenance – Lamotrigine has greater effect on recurrence of depression in maintenance Goodwin FK. Rationale for using lithium in combination with other mood stabilizers in the management of bipolar disorder. J Clin Psychiatry. 2003 May;64 Suppl 5:18-24.
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 and 32: Rationale For Long Term Treatment W
Page 33 and 34: Relapse in Bipolar Disorder • Des
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: Potential Toxicity of Long Term Lit
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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