Current Therapeutic Profile of Lithium

WITH The advent of new pharmacotherapies for bipolar disorder, it may be an opportune time to look at the course of events that initiated the possibility of specific pharmacotherapy for this disorder. It is now 48 years since Cade's original report about the effects of lithium carbonate treatment in cases of mania was published.¹The time course of lithium therapy introduction in 1949, and its subsequent development, is concomitant with the span of the professional career of one of us (S.G.). The article by Schou²in this issue of theARCHIVESraises several key points that we would like to address. MAGNITUDE OF LITHIUM EFFECTIVENESS IN MANIA The early studies of lithium in the treatment of acute mania reported high effectiveness. In Cade's initial open study,¹all 10 patients with mania clearly responded to lithium administration. In subsequent, controlled studies, high (~70%-80%), effectiveness of lithium therapy