Utility of Lithium for Treating Mania in Bipolar Disorder
It was John Frederick Joseph Cade who discovered the mood stabilisation effects of Lithium. He published the results of his study in the medical Journal of Australia dated September 1949. He was making use of animal models for his study. His studies were mostly carried out in mice. Uric acid is highly insoluble. For this reason Cade chose its lithium salt, lithium Urate.
He observed that the compound Lithium Urate had calming effects on mice. After some more vigorous studies he noticed that Lithium though had insignificant effects in depressed patients it offered dramatic relief to manic patients.
Why is Lithium So Indispensable for Treating Mania in Bipolar Disorder?
Lithium is still used despite its side effects because of its inevitability for reducing both the symptoms as well as the frequency of their occurrence in patients with manic disorders. Some valid studies found that the response rate was 70-80% for the initial as well as the maintenance treatments (treatment provided to help the main treatment succeed) of mania. The discontinuation of Lithium is recommend only when it is absolutely necessary to do so. Almost all studies show that gradual reduction of doses results in a much lower risk of relapse. Abrupt withdrawal was found to cause some troublesome symptoms. More importantly after the withdrawal of lithium the suicidal tendency goes back to its original intensity, mostly during first six to twelve month period. So a strict vigil needs to be maintained by the Psychiatrist and the caregivers.