Countering the declining use of lithium therapy: a call to arms
Abstract For over half a century, it has been widely known that lithium is the most efficacious treatment for bipolar disorder. Yet, despite this, its prescription has consistently declined over this same period of time. A number of reasons for this apparent disparity between evidence and clinical p...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2023-08-01
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| Series: | International Journal of Bipolar Disorders |
| Online Access: | https://doi.org/10.1186/s40345-023-00310-x |
| _version_ | 1797578509022920704 |
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| author | Gin S. Malhi Erica Bell Maedeh Jadidi Michael Gitlin Michael Bauer |
| author_facet | Gin S. Malhi Erica Bell Maedeh Jadidi Michael Gitlin Michael Bauer |
| author_sort | Gin S. Malhi |
| collection | DOAJ |
| description | Abstract For over half a century, it has been widely known that lithium is the most efficacious treatment for bipolar disorder. Yet, despite this, its prescription has consistently declined over this same period of time. A number of reasons for this apparent disparity between evidence and clinical practice have been proposed, including a lack of confidence amongst clinicians possibly because of an absence of training and lack of familiarity with the molecule. Simultaneously, competition has grown within the pharmacological armamentarium for bipolar disorder with newer treatments promoting an image of being safer and easier to prescribe primarily because of not necessitating plasma monitoring, which understandably is appealing to patients who then exercise their preferences accordingly. However, these somewhat incipient agents are yet to reach the standard lithium has attained in terms of its efficacy in providing prophylaxis against the seemingly inevitable recrudescence of acute episodes that punctuates the course of bipolar disorder. In addition, none of these mimics have the additional benefits of preventing suicide and perhaps providing neuroprotection. Thus, a change in strategy is urgently required, wherein myths regarding the supposed difficulties in prescribing lithium and the gravity of its side-effects are resolutely dispelled. It is this cause to which we have pledged our allegiance and it is to this end that we have penned this article. |
| first_indexed | 2024-03-10T22:23:52Z |
| format | Article |
| id | doaj.art-1b09ce3008e4415fa6ad5adecb2895de |
| institution | Directory Open Access Journal |
| issn | 2194-7511 |
| language | English |
| last_indexed | 2024-03-10T22:23:52Z |
| publishDate | 2023-08-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | International Journal of Bipolar Disorders |
| spelling | doaj.art-1b09ce3008e4415fa6ad5adecb2895de2023-11-19T12:11:11ZengSpringerOpenInternational Journal of Bipolar Disorders2194-75112023-08-011111610.1186/s40345-023-00310-xCountering the declining use of lithium therapy: a call to armsGin S. Malhi0Erica Bell1Maedeh Jadidi2Michael Gitlin3Michael Bauer4Academic Department of Psychiatry, Kolling Institute, Northern Clinical School, Faculty of Medicine and Health, The University of SydneyAcademic Department of Psychiatry, Kolling Institute, Northern Clinical School, Faculty of Medicine and Health, The University of SydneyAcademic Department of Psychiatry, Kolling Institute, Northern Clinical School, Faculty of Medicine and Health, The University of SydneyDepartment of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles (UCLA)Department of Psychiatry and Psychotherapy, Faculty of Medicine, Technische Universität DresdenAbstract For over half a century, it has been widely known that lithium is the most efficacious treatment for bipolar disorder. Yet, despite this, its prescription has consistently declined over this same period of time. A number of reasons for this apparent disparity between evidence and clinical practice have been proposed, including a lack of confidence amongst clinicians possibly because of an absence of training and lack of familiarity with the molecule. Simultaneously, competition has grown within the pharmacological armamentarium for bipolar disorder with newer treatments promoting an image of being safer and easier to prescribe primarily because of not necessitating plasma monitoring, which understandably is appealing to patients who then exercise their preferences accordingly. However, these somewhat incipient agents are yet to reach the standard lithium has attained in terms of its efficacy in providing prophylaxis against the seemingly inevitable recrudescence of acute episodes that punctuates the course of bipolar disorder. In addition, none of these mimics have the additional benefits of preventing suicide and perhaps providing neuroprotection. Thus, a change in strategy is urgently required, wherein myths regarding the supposed difficulties in prescribing lithium and the gravity of its side-effects are resolutely dispelled. It is this cause to which we have pledged our allegiance and it is to this end that we have penned this article.https://doi.org/10.1186/s40345-023-00310-x |
| spellingShingle | Gin S. Malhi Erica Bell Maedeh Jadidi Michael Gitlin Michael Bauer Countering the declining use of lithium therapy: a call to arms International Journal of Bipolar Disorders |
| title | Countering the declining use of lithium therapy: a call to arms |
| title_full | Countering the declining use of lithium therapy: a call to arms |
| title_fullStr | Countering the declining use of lithium therapy: a call to arms |
| title_full_unstemmed | Countering the declining use of lithium therapy: a call to arms |
| title_short | Countering the declining use of lithium therapy: a call to arms |
| title_sort | countering the declining use of lithium therapy a call to arms |
| url | https://doi.org/10.1186/s40345-023-00310-x |
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