Lithium

Lithium utility and toxicity are reviewed. Lithium continues to be the most useful agent available for the prophylaxis and treatment of bipolar illness. Lithium augmentation of antidepressants is useful in treatment-resistant unipolar depression. Utility in other psychiatric disorders, such as schizoaffective, alcoholism, or aggressive behavior, is documented only when a significant affective component coexists. In internal medicine, lithium has proven useful in the prophylaxis of cluster headaches and in ameliorating chemotherapy-induced neutropenia. Other miscellaneous uses in both psychiatry and medicine have been anecdotally reported and are reviewed. However, the use of lithium may be limited by acute and chronic toxic side effects. Acute toxicity almost always manifests as central nervous system (CNS) dysfunction, and the degree of toxicity usually parallels the extent of CNS dysfunction. Chronic toxic manifestations effect cardiac, renal, and endocrine systems. In fetu exposure may be teratogenic.