Key Treatment Studies of Lithium in Manic-Depressive Illness: Efficacy and Side Effects

Lithium is the most extensively studied single psychopharmacologic agent. This review summarizesefficacy results of key studies in manic-depressive illness, the increasingly practical findings regardingpredictors of response, and the implications of the increasingly better understood adverse effectprofile of lithium. A recent well-designed study confirms earlier studies regarding the markedeffectiveness of lithium in alleviation of acute mania. Early maintenance studies of marked superiorityof lithium over placebo have been countered by recent open reports of lesser effectiveness. A recentrandomized study provides support for the efficacy of lithium in maintenance therapy, but a satisfactoryassessment of the effectiveness of lithium for maintenance and its optimal role requires furtherstudy. Many of the adverse effects of lithium can be addressed by dosage reduction, use of sustainedreleaselithium, or combination therapy.