When and how to use lithium.

Acta Psychiatrica Scandinavica
S A Barroilhet, S N Ghaemi

Abstract

Lithium is an old proven medication, but it is infrequently used in current practice. This review examines evidence for its benefits and risks and provides clinical guidance to its use. Narrative review. Besides its benefit in bipolar illness, lithium has important underappreciated proven benefits in prevention of unipolar depression and suicide. Emerging data support neurobiological benefits for cognition and possible dementia prevention. Likely benefits also exist in low doses for mood temperaments (cyclothymia and hyperthymia). High doses (over 1.0 mmol/L) should be avoided since they increase side effects, complications associated with long-term use, and risk of toxicity. Conversely, low dosing can be legitimate, especially for suicide and dementia prevention. Nuisance side effects of lithium may affect adherence, and medically serious side-effects can occur. Managing strategies are available for side effects. Lithium is the most effective medication in psychiatry, because it has disease-modifying, not just symptomatic, effects. It is effective not only for bipolar illness but also for prevention of suicide, episodes of unipolar depression, mood temperaments, and possibly dementia. Its many benefits need better appreciation...Continue Reading

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Citations

Jan 28, 2021·Acta Psychiatrica Scandinavica·Estela SalagreUNKNOWN PEPs Group
Jan 19, 2021·Acta Psychiatrica Scandinavica·M Bauer
Mar 2, 2021·International Journal of Geriatric Psychiatry·Marinke FlapperRob Kok

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