Without a doubt, lithium is an essential medication for people with bipolar disorders and represents the most valuable treatment option in the prophylactic treatment for more than seven decades. Amazingly, this ubiquitous occurring trace element can be considered the psychotropic medication with the longest clinical application in modern psychopharmacology. From a historical perspective, since its establishment in the field of clinical psychopharmacology in the mid of the 20th century, several new aspects have been discovered in basic and clinical research, including anti-suicidal and antidepressant effects when used as an augmentation strategy. There is ample evidence that the capability of lithium long-term treatment to reduce the suicidal risk distinguishes it from the other mood stabilizers used in bipolar disorder. Furthermore, basic research has solidly demonstrated in the previous decade that lithium possesses neuroprotective properties in animals and in vitro, and likely in humans as well when used prophylactically in people with bipolar disorder.
However, although studied for decades, there are still a lot of open questions around lithium. Examples include: Does lithium have the potential to prevent dementia if used in very early stages of the disease or even prophylactically in people at high familiar risk? Does lithium have acute anti-suicidal effects? Why do the prescription rates decline in many countries given the extraordinary evidence of its effectiveness in the maintenance treatment of bipolar disorders and recommendations in international treatment guidelines? Does lithium long-term treatment reduce the risk of developing cancer? And being infected with the SarsCoV2 virus? Why does lithium in drinking water, where it appears as a trace element, reduce the suicide rate, although the concentrations are much higher when used as a medication to treat bipolar disorders? Are there ways to better predict the population among long-term lithium users who develop chronic renal disease? What are the biological mechanisms leading to the profound effectiveness to prevent episodes of mania and depression?
This thematic series, which intends to approach some of these unanswered questions about lithium from a broad and multidisciplinary perspective, is centred on these and other unanswered concerns. The ultimate goal is to assist in unravelling the biological mechanisms behind lithium’s clinical effects in order to enhance diagnosis and therapy of bipolar disorders.
