LITHIUM - EARLY DEVELOPMENT, TOXICITY, AND RENAL-FUNCTION

The report of the effectiveness of lithium in the treatment of mania b y John Cade was followed by a number of studies confirming his observa tions and developing guidelines for safe and effective use. Premature rejection of lithium on safety grounds denied many patients the benefi t of treatment and may have cost more lives than it saved. A similar s afety alarm was triggered by reports of kidney damage in the late 1970 s. Subsequent reports have questioned the significance of anatomical f indings, and functional in significance and relationship to lithium tr eatment. Recent findings support the conclusion that progressive impai rment and relationship to lithium in patients during lithium maintenan ce is the exception rather than the rule and is related more to lithiu m intoxication, maintenance plasma lithium levels, concurrent medicati ons, somatic illness, and age than on time on lithium. Guidelines for lithium use and monitoring of renal function ale outlined. (C) 1998 Am erican College of Neuropsychopharmacology. . Published by Elsevier Sci ence Inc.