Lithium

Lithium has been used as a medicine for over a century, originally in the treatment of gout, and in the early 1940's lithium was used for cardiac patients as a salt in a sodium chloride free diet. However because of side effects its use for these patients was abandoned.

Lithium is used as a psychiatric treatment against the recurrence of mania and as a treatment, and prophylaxis for, depressive disorders. Lithium may have some antidepressant effects but these are less than those of less-toxic agents such as tricyclics. Lithium has also been claimed to be of use in reduction of premenstrual tension.

Lithium-enhanced use of high dose tricyclics is a treatment alternative for depressive illness where the use of high dose tricyclics alone has failed to have a therapeutic effect (see notes).

The summary of product characteristics should be consulted before prescribing this drug.

Notes:

• dosulepin, phenelzine, combined antidepressants, and lithium augmentation of antidepressants should only be routinely initiated by specialist mental health professionals, including General Practitioners with a Special Interest in Mental Health (1)

Reference:

1. NICE (December 2004).Depression Management of depression in primary and secondary care