Countering the declining use of lithium therapy: a call to arms

Research output: Contribution to journalReview articleContributedpeer-review

Contributors

  • Gin S. Malhi - , University of Sydney, Royal North Shore Hospital, University of Oxford (Author)
  • Erica Bell - , University of Sydney, Royal North Shore Hospital (Author)
  • Maedeh Jadidi - , University of Sydney, Royal North Shore Hospital (Author)
  • Michael Gitlin - , University of California at Los Angeles (Author)
  • Michael Bauer - , Department of Psychiatry and Psychotherapy (Author)

Abstract

For over half a century, it has been widely known that lithium is the most efficacious treatment for bipolar disorder. Yet, despite this, its prescription has consistently declined over this same period of time. A number of reasons for this apparent disparity between evidence and clinical practice have been proposed, including a lack of confidence amongst clinicians possibly because of an absence of training and lack of familiarity with the molecule. Simultaneously, competition has grown within the pharmacological armamentarium for bipolar disorder with newer treatments promoting an image of being safer and easier to prescribe primarily because of not necessitating plasma monitoring, which understandably is appealing to patients who then exercise their preferences accordingly. However, these somewhat incipient agents are yet to reach the standard lithium has attained in terms of its efficacy in providing prophylaxis against the seemingly inevitable recrudescence of acute episodes that punctuates the course of bipolar disorder. In addition, none of these mimics have the additional benefits of preventing suicide and perhaps providing neuroprotection. Thus, a change in strategy is urgently required, wherein myths regarding the supposed difficulties in prescribing lithium and the gravity of its side-effects are resolutely dispelled. It is this cause to which we have pledged our allegiance and it is to this end that we have penned this article.

Details

Original languageEnglish
Article number30
JournalInternational journal of bipolar disorders
Volume11
Issue number1
Publication statusPublished - Dec 2023
Peer-reviewedYes

External IDs

ORCID /0000-0002-2666-859X/work/150883560

Keywords