Lithium in the Treatment of Mania

Abstract

Since the original discovery of the antimanic properties of lithium nearly 30 years ago,¹ a large number of studies, as well as extensive clinical experience, have confirmed the efficacy of this drug for the treatment of the manic phase of manic-depressive illness. The recent focus of questions concerning the role of lithium in the treatment of mania has shifted from efficacy per se to comparisons with other drug treatments and the related issue of specificity. This review will, therefore, focus on controlled studies comparing lithium with neuroleptics, following a brief historical review of the earlier studies. The studies comparing lithium with neuroleptics are of special importance not only from a practical point of view but also theoretically, in that they bear on the question of the specificity of lithium against the manic syndrome—a question with implication for the underlying pathophysiology of mania. OPEN SINGLE-BLIND STUDIES Table 1 summarizes the