Abstract
ObjectivesThe efficacy of lithium in bipolar disorder is widely accepted for many years. It is still considered as the gold standard in most international guidelines. Lithium is indicated in the treatment of mania, of depressive episodes and in the prevention of mania and depression. The objective of this paper is to focus on scientific data supporting the interest of lithium in the management of bipolar disorder. MethodsA Medline search of papers published between 1950 and 2013 and focusing on the efficacy of lithium in bipolar disorder was performed. The content of this paper was mainly based on the most recent studies comparing lithium to placebo and to new drugs potentially effective in the treatment of bipolar disorder. ResultsThis review shows that the evidence is strong in the treatment of mania and in the prevention of recurrences. The results in the treatment of depression are more conflicting. Some studies suggested both positive and negative predictors of response to lithium in the treatment of mania. The serum-lithium level associated with an optimal preventive effect against manic and depressive recurrence is probably between 0,6 and 0,8mEq/L. ConclusionToday, there is no doubt about the efficacy of lithium in the treatment of mania and in the prevention of mania and depression.
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