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Mood Stabilizers: Lithium

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NeuroPsychopharmacotherapy

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Abstract

The developmental history of lithium and its physicochemical properties, pharmacokinetics, and mechanisms of action are presented. Among the latter, the effect on the phosphatidylinositol (PI) system and the inhibition of the glycogen synthase kinase 3beta (GSK-3β) activity are the most important. Lithium makes a prototype of the mood-stabilizing drug, is regarded as the drug of the first choice for the prophylaxis of bipolar disorders, and, as a monotherapy, surpasses all other mood stabilizers. The drug can also be used in the treatment of acute episodes of mood disorders, especially for the augmentation of antidepressants in treatment-resistant depression. Lithium possesses significant anti-suicidal properties, the strongest among all mood stabilizers. The drug exerts antiviral, especially against herpes infection, and immunomodulatory influence. The evidence has also been accumulated for the neurotrophic and neuroprotective effects of lithium. Neuroimaging studies in bipolar subjects showed an increase in the volume of some brain structures during lithium administration. Lithium therapy is associated with numerous side effects, most of them can be successfully managed. Given lithium superiority for the prophylaxis of mood disorders, together with its anti-suicidal, immunomodulatory, and neuroprotective effects, the drug is currently greatly underprescribed, and its therapeutic potential in patients with bipolar disorder is not sufficiently utilized.

Recently, epidemiological data suggest an association between lithium intake and dementia risk reduction. In experimental models of neurodegenerative disorders, lithium exhibits significant therapeutic activity. Promising results have also been obtained in some clinical studies.

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Authors and Affiliations

  1. Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland

    Janusz K. Rybakowski

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  1. Janusz K. Rybakowski
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Correspondence to Janusz K. Rybakowski .

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Editors and Affiliations

  1. Clinic and Policlinic for Psychiatry, Psychosomatics and Psychotherapy, University Hospital Wuerzburg, Wuerzburg, Germany

    Peter Riederer

  2. Institute of Psychological Medicine (IPM), Soyen, Germany

    Gerd Laux

  3. Centre for Research Promotion and Support, Fujita Health University, Toyoake, Aichi, Japan

    Toshiharu Nagatsu

  4. Center Translational Res Neurol Diseases, Dalian Med Uni Shanghai Inst Health Sc Center Translational Res Neurol Diseases, Dalian, China

    Weidong Le

  5. Würzburg, Germany

    Christian Riederer

Section Editor information

  1. Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany

    Andreas Menke

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Rybakowski, J.K. (2022). Mood Stabilizers: Lithium. In: Riederer, P., Laux, G., Nagatsu, T., Le, W., Riederer, C. (eds) NeuroPsychopharmacotherapy. Springer, Cham. https://doi.org/10.1007/978-3-030-62059-2_45

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  • DOI: https://doi.org/10.1007/978-3-030-62059-2_45

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-62058-5

  • Online ISBN: 978-3-030-62059-2

  • eBook Packages: MedicineReference Module Medicine

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