Lithium and Bipolar Disorder

Lithium salts are frequently used to treat bipolar disorder. Lithium is a medication known as a mood stabilizer, and the use of it to treat bipolar disorder was first described in medical literature by Australian psychiatrist Dr. John Cade in 1949. However, use of lithium predates this significantly: ancient physicians and healers advised their mentally ill patients to drink from alkali springs, because the curative water contained lithium.

Lithium, anticonvulsants and atypical antipsychotics all treat mania, but they are less effective at treating depression. Therefore, in cases of bipolar II disorder (in which depression is the dominant feature) antidepressant medications are often used instead of lithium. However, unfortunately antidepressants can trigger mania in bipolar patients, so the practice remains controversial.

Side Effects of Lithium

Lithium can manage the symptoms of bipolar disorder, but some of the drug’s side effects make using this drug undesirable. The side effects of lithium include gastro-intestinal difficulties such as constipation, nausea and diarrhea, as well as water retention and increased blood pressure.

However, lithium may also cause weight gain and memory problems. Another problem with lithium is that it has a narrow window of effectiveness. In too small a dose, lithium will be completely ineffective, but in too high a dose it can be toxic.

However, effective therapeutic doses are near the level of toxicity, so it is necessary to test the patient’s blood on a regular basis to determine lithium levels.

Problems Associated with Treating Bipolar Disorder

Bipolar disorder cannot be cured, but rather must be treated to manage its symptoms. The first problem associated with treating bipolar disorder is receiving an accurate medical diagnosis.

Bipolar disorder often produces depressive symptoms, so it is very easy for a diagnosing physician to miss the disorder and diagnose major depression instead. As mentioned above, this can cause serious problems since antidepressant medications may trigger mania in someone who is bipolar.

Treatment compliance can also be an issue with bipolar patients who may discontinue their medication once they feel better. Since bipolar disorder is never cured, discontinuing medication will almost invariably result in more symptoms. Lastly, substance abuse is a big issue for many bipolar patients. Drug use can complicate a diagnosis and cause a diagnosing physician to miss the condition. Drug use can also interfere with treatment, since drugs can alter the effectiveness of mood stabilizers and aggravate the symptoms of bipolar disorder.