This podcast episode is about lithium, why it is the most effective psychiatric drug, and also very safe when used at the right doses. Frederick Goodwin MD used to say: “If you can’t or won’t use lithium, get out of the business of treating bipolar disorder.” I might expand it to say if you can’t or won’t use lithium, then you can’t treat psychiatric illness well in general, including outside bipolar illness. Lithium is effective unipolar depression as well, not just bipolar illness, and works as well if not better for depression as it does for mania. Much of what is called “depression” or “anxiety” turns out to be mood temperaments, like cyclothymia, which respond well to low-dose lithium. At low doses of 300-600 mg/d, lithium is very effective and very well tolerated, with limited side effects and only 1% risk of kidney impairment at 20 years of treatment or longer. It’s the only drug proven to prevent suicide, likely has benefits in prevention in dementia too, and decreases medical mortality. Other psychiatric drugs that are widely used, like antidepressants, do not have those effects. In short, it’s safe and very effective, and should be used much more than it is. If clinicians are uncomfortable using it, they need to learn that their discomfort is misplaced. Frederick Goodwin was right even more than he knew: Clinicans who can’t or won’t use lithium won’t be able to treat psychiatric illness well.

Here is the link for the 3-Part Live Masterclass : https://psychiatryletter.com/10-truths-and-10-fallacies-of-psychopharmacology-open/?utm_term=lithiumis

Reference: https://pubmed.ncbi.nlm.nih.gov/32526812/

Barroilhet SA, Ghaemi SN. When and how to use lithium. Acta Psychiatr Scand. 2020 Sep;142(3):161-172.