Lithium salts have strong medical properties in neurological disorders such as bipolar disorder and lithium-responsive headaches (Pereira da Silva Neto and James Almeida, 2010; Lindner et al., 2023; Silva-Néto et al., 2019). They have recently gathered attention due to their potential preventive effect in viral infections (Ferensztajn-Rochowiak and Rybakowski, 2023; Rybakowski, 2022). Though the therapeutic effect of lithium was documented by Cade in the late 1940s, its underlying mechanism of action is still disputed (Malhi and Outhred, 2016). Acute lithium exposure has an activating effect on excitable organic tissue and organisms, and is highly toxic (Schou, 1957; Butler-Munro et al., 2010; Izsak et al., 2021; Yip and Yeung, 2007). Lithium exposure is associated with a strong metabolic response in the organism, with large changes in phospholipid and cholesterol expression (López-Corcuera et al., 1988; Pettegrew et al., 2001; Aliyazicioğlu et al., 2007). Opposite to acute exposure, this metabolic response alleviates excessive cellular activity (Mertens et al., 2015; Stern et al., 2018; Santos et al., 2021). The presence of lithium ions strongly affects lipid conformation and membrane phase unlike other alkali ions (Hauser and Shipley, 1983), with consequences for membrane permeability, buffer property and excitability. This review investigates how lithium ions affect lipid membrane composition and function, and how lithium response might in fact be the body's attempt to counteract the physical presence of lithium ions at cell level. Ideas for further research in microbiology and drug development are discussed.
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