Current status of lithium therapy in affective disorders

Lithium was introduced into medicine more than one hundred years ago and into psychiatry 25 years ago. In spite of this long history, it is only within the last 5-10 years that the unique properties and particular advan tages of lithium as a drug have become recognized. Its usage is now sprea ding rapidly, and almost every month we hear of new uses being claimed for lithium. I want to emphasize, however, that at the present time only two uses of lithium are fully established: the therapeutic use in mania, and the prophylactic use in recurrent endogenous affective disorders. All other uses are based on evidence which is not yet fully conclusive even though in some instances it is quite strong. Systematic trials are required fox further substantiation. We must keep our minds open to new developments in the field, for there is presumably still much to be learned about this deceptively simple and yet so enigmatic drug, the lithium ion. This paper deals with indications for lithium treatment, the proven, the tentative, and the disproven. Another paper (Schou, 1975) describes the practical problems of lithium treatment.