grace367 asked this question on 4/28/2000:

Can the drug Lithium be used to treat bipolar?

izzybelle gave this response on 4/28/2000:

Most definitely. Lithium is a commonly used treatment for a bipolar disorder. There are specific symptoms that lithium treats though, which are the swings between mania and depression. It is least effective if the person with the disorder uses any other illegal drugs or if the bipolar is a secondary condition. Lithium has been proven to have significant antidepressant properties when compared with other treatments such as Divalproex and Carbamazepine.

What would indicate lithium would be an effective treatment:

'Previous good response to lithium, positive family history of bipolar disorder and response to lithium, pure but not severe mania, classical bipolar disorder with an episode sequence of mania-depression-euthymia and adequate serum lithium levels are all associated with good response to lithium' (Faedda et al, 1991; Gelenberg et al, 1989: Groff et al, 1993). --Saying if there is a hereditary link and good positive reaction to lithium treatment, there is a good possibility it will be effective. Also if it is a pure mania, with the mood swings of manic to depression, and if if there body's chemistry looks like it will take it, there is a greater chance of being successful.

What has proven to not be effective with lithium treatments:

'Multiple previous episodes, rapid cycling and mixed states, significant comorbidity with alcohol or substances and personality disorder and serum levels below 0.6 mmols/l are all predictive of failure to respond to lithium' (Calabrese et al, 1996). ---Saying that if they are cycling through their moods rapidly, if they are using any alcohol or other illegal drugs, or if their body's chemistry is not at a point where it could accept lithium, then it will most likely not be a successive treatment.

Here is some information regarding side effects and long term effects:

'Long term adverse effects on thyroid functioning and the kidneys, especially in patients with a previous or family history of renal problems, suggest the value of caution and the usefulness of regular monitoring. Lithium has a narrow therapeutic range and toxicity can be induced by changes in electrolyte and fluid balance. Lithium can be lethal in overdose.

Patients should be informed about these potential interactions in advance, and screened closely for the use of other medications, including over the counter medications, when side effects appear.'Gitlin MJ, Jamison KR. 1984. Lithium Clinics: Theory and Practice. Hosp Comm Psychiatry. 35:363-368.

Hope this helps. I know that it is a lot of information, let me know if you need any more clarification of any of it.

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