Clinical use of lithium in affective disorders.

Abstract

Lithium was discovered by A. Arfwedson in the laboratory of Berzelius in 1817, and named lithium because it was extracted from stone 'lithos' in Greek. It is now known to occur in at least 145 minerals, many plant and animal tissues, including most human organ tissues, although its metabolic significance is not known. No biochemical or physiological system has been shown to require it, aithough it is tolerated in much greater amounts than other non-biologically occurring metals. Lithium occurs in many spring waters which have been used for centuries to treat a variety of disorders. As early as the 5th century AD, Caelius Aurelianus recommended mineral water (probably high in lithium) to treat manic excitement. In the latter half of the 19th century, the lithium content of mineral springs was advertised as a cure for many disorders, such as gout, renal calculi and rheumatism. The basis for this use was laboratory experiments with uric acid which have since shown to be specious. In the 1920's lithium was used as an antiepileptic, a tonic and hypnotic. During the 1940's in the USA, lithium chloride was used as a salt substitute, but it was removed from the market when a number of poisonings and at least 4 deaths were reported. These occurred because lithium can be dangerous in persons with heart and kidney disease, precisely those who use a salt substitute (Corcoran et aI., 1949).