Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland.
Department of Psychiatric Nursing, Poznan University of Medical Sciences, Poznan, Poland.
Int J Psychiatry Clin Pract. 2020 Nov;24(4):330-340. doi: 10.1080/13651501.2020.1775855. Epub 2020 Jun 17.
A narrative review of past, present, and future of lithium use in psychiatry.
The most important references on the topic were reviewed with special emphasis on the author's works.
The history of medical and psychiatric use of lithium dates back to more than one and a half-century ago. However, modern psychiatric history began with the publication of John Cade, in 1949, showing a therapeutic effect of lithium in mania. Currently, lithium is a drug of choice as a mood-stabilizer for the maintenance treatment of the bipolar disorder. The second most important use of lithium is probably augmentation of antidepressants in treatment-resistant depression. In addition to its mood-stabilizing properties, lithium exerts anti-suicidal, immunomodulatory, and neuroprotective action. The drug may protect against dementia and some promising effects of lithium in neurodegenerative disorders have been observed.
Given the clinical and biological properties of lithium, this drug is presently greatly underutilized in mood disorders. Therefore, the efforts should be undertaken for challenging a skepticism about the use of lithium and optimizing its long-term administration. In such a way, more patients with mood disorders can become the beneficiaries of lithium's therapeutic action. KEY POINTS Lithium is a drug of choice as a mood-stabiliser for the maintenance treatment of bipolar disorder. Augmentation of antidepressants by lithium is one of the best strategies in treatment-resistant depression. Lithium exerts anti-suicidal, immunomodulatory, and neuroprotective action and may protect against dementia. Despite the evidence for the efficacy and added favourable properties, lithium is greatly underutilised in mood disorders. Challenging a scepticism about the use of lithium and optimising its long-term administration can make more patients with mood disorders the beneficiaries of lithium's therapeutic action.
对锂在精神病学中的过去、现在和未来进行叙述性综述。
对该主题的最重要参考文献进行了回顾，特别强调了作者的作品。
医学和精神病学中锂的使用历史可以追溯到一个半多世纪以前。然而，现代精神病学史始于 1949 年 John Cade 的发表，他展示了锂在躁狂症中的治疗作用。目前，锂是作为双相情感障碍维持治疗的首选心境稳定剂。锂的第二大重要用途可能是增强抗抑郁药治疗难治性抑郁症。除了稳定情绪的特性外，锂还具有抗自杀、免疫调节和神经保护作用。该药可能具有预防痴呆的作用，并且在神经退行性疾病中观察到了锂的一些有前景的作用。
鉴于锂的临床和生物学特性，这种药物在心境障碍中的应用目前大大不足。因此，应努力克服对锂使用的怀疑，并优化其长期给药。通过这种方式，更多的心境障碍患者可以受益于锂的治疗作用。
锂是双相情感障碍维持治疗的首选心境稳定剂。
锂增强抗抑郁药是治疗难治性抑郁症的最佳策略之一。
锂具有抗自杀、免疫调节和神经保护作用，可能预防痴呆。
尽管有疗效和附加有利特性的证据，但锂在心境障碍中的应用大大不足。
挑战对锂使用的怀疑并优化其长期给药可以使更多的心境障碍患者受益于锂的治疗作用。
