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Lithium in Psychiatry / Litio en Psiquiatría
Baldessarini, Ross J; Tondo, Leonardo.
  • Baldessarini, Ross J; Harvard Medical School. Department of Psychiatry. Massachusetts. US
  • Tondo, Leonardo; Harvard Medical School. Department of Psychiatry. Massachusetts. US
Rev. neuro-psiquiatr. (Impr.) ; 76(4): 189-203, oct.-dic. 2013.
Article in English | LILACS, LIPECS | ID: lil-721967
ABSTRACT

Background:

Lithium is a light, metallic element and minerals containing it are most abundant in the Andes. John Cade introduced lithium carbonate for the treatment of mania in 1949, opening the era of modern clinical psychopharmacology. Lithium remains the most extensively studied mood-stabilizing agent. It has had a revolutionary impact in supporting bipolar manic-depressive disorder as a discrete diagnosis, and on psychiatric therapeutics.

Methods:

We survey the development of lithium treatment in psychiatry, including findings concerning effects on suicide.

Results:

Lithium is the most extensively studied treatment for bipolar disorder and the prototypical mood-stabilizing agent, despite emergence of anticonvulsants and modern antipsychotics. In addition to limiting recurrences of mania, and some reduction of recurrences of bipolar depression, lithium has demonstrated protective effects against suicide. All treatments for bipolar disorder have notable limitations, including sometimes serious adverse effects, incomplete prevention of recurrences of mania and limited prevention of depression, which accounts for three-quarters of the approximately 50% time-ill in long-term follow-up with standard treatments. Lithium can be toxic in untreated overdoses; safe dosing requires monitoring of serum concentrations. Lithium also may have mild teratogenic effects, but far less than those of anticonvulsants used for bipolar disorder.

Conclusions:

Lithium opened the era of modern psychopharmacology and continues as the best-established mood-stabilizing treatment for bipolar disorder as well as having strong evidence of suicide-preventing effects.
RESUMEN
Antecedentes Litio es un elemento metálico ligero y los minerales que lo contienen abundan predominantementeen la región andina. John Cade introdujo el uso de carbonato de litio para el tratamiento de manía en 1949, iniciando con ello la era de la moderna psicofarmacología clínica. Litio se mantiene como el más extensamente estudiando agente estabilizador del ánimo. Ha tenido un impacto revolucionario en la preservación del trastorno maniaco-depresivo o bipolar como un diagnóstico discreto y en el campo de la terapéutica psiquiátrica.

Métodos:

Se examina el desarrollo histórico del tratamiento con litio en psiquiatría, incluyendo hallazgos en relación a su efecto sobreconducta suicida. HallazgosLitio es el tipo de tratamiento más extensamente estudiado en el manejo de trastorno bipolar disorder, constituido como el prototipo de agente estabilizador del ánimo, a pesar de la emergencia de agentes anticonvulsivantes y de los antipsicóticos modernos. Además de limitar la recurrencia de episodios maniacos y reducir en algo las recurrencias de depresión bipolar, litio ha demostrado efectos protectores en relación a suicidio y conducta suicida. Todos los tipos de tratamiento de trastorno bipolar tienen limitaciones notables, incluyendo algunas veces serios efectos adversos, prevención incompleta de recurrencias de manía y prevención limitada de depresión, todo lo cual constituye las tres cuartas partes de aproximadamente el 50 % de tiempo con enfermedad en estudios de seguimiento a largo plazo con tratamientos estándar.
Subject(s)

Full text: Available Index: LILACS (Americas) Main subject: Suicide / Bipolar Disorder / Depression / Lithium Type of study: Observational study / Prognostic study Language: English Journal: Rev. neuro-psiquiatr. (Impr.) Year: 2013 Type: Article Institution/Affiliation country: Harvard Medical School/US

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Full text: Available Index: LILACS (Americas) Main subject: Suicide / Bipolar Disorder / Depression / Lithium Type of study: Observational study / Prognostic study Language: English Journal: Rev. neuro-psiquiatr. (Impr.) Year: 2013 Type: Article Institution/Affiliation country: Harvard Medical School/US