Evaluation of lithium treatment in alcoholism

In psychiatric practice, lithium prevents manic depressives recidivism. Lithium could also be useful in non-manic-depressive conditions with a reduction of aggression and impulsivity. From the observation that alcoholics often present mood swings and impulsivity, several authors studied the effects of maintenance doses of lithium on alcohol intake and the depressive symptoms of alcoholics. This article reviews all the published controlled and uncontrolled studies on the effects of lithium in chronic alcoholics. Wren, Kline and colleagues firs demonstrated that lithium treatment could significantly decrease the number of disabling alcoholic episodes and that its effect was independent of an effect on the depressive symptoms. These initial optimistic conclusions were not confirmed by later controlled studies involving a larger number of patients. Most of the recent studies failed to demonstrate a significant effect of lithium on the depressive symptoms of alcoholics. Thus, it is now established that lithium is not an effective treatment of affective disorders in alcoholics. The latest published studies also suggest that lithium treatment does not decrease alcohol intake or craving for alcohol in either depressed or non-depressed alcoholics.