Lithium therapy

Affective (mood) disorders are common in all ages often chronic or recurren t, destructive of personal and social functioning with significant morbidit y and mortality. Diagnosis still rests on the clinical skills of interview, observation and a knowledge of the disorders. Lithium is simple, cheap and effective although underused. It is the main pharmacological agent current ly used in bipolar disorders and as an adjunct in other affective disorders . While it does have a narrow therapeutic window and can cause serious morb idity itself, it is safe when delivered properly reducing both morbidity an d mortality. Lithium therapy should only be started in a specialist psychia tric setting but other clinicians will be involved wither in maintenance tr eatment or in treating patients for separate disorders who happen also to b e on lithium.