ReviewInternational journal of bipolar disorders2024
Why is lithium [not] the drug of choice for bipolar disorder? a controversy between science and clinical practice.
Review in International journal of bipolar disorders, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Pooled it
- Real-World Assessment of Healthcare Resource Utilization-Defined Manic and Depressive Events Among Patients with Bipolar I Disorder Treated with Cariprazine Versus Aripiprazole.Advances in therapy · 2026Article
- Time to lithium: A case register study of lithium initiation in bipolar disorder.Journal of psychopharmacology (Oxford, England) · 2026Article
- Baseline NMR lipoprotein profiles in lithium-naïve bipolar disorder patients who later showed weight gain during lithium therapy: a pilot study.International journal of bipolar disorders · 2026Article
- Early health economic assessment of eLiActa neuropsychiatrica · 2026Article
- Understanding the Current State of Play of Early Intervention for Bipolar Disorder: Qualitative Analysis of Consultations With International Stakeholders.Bipolar disorders · 2026Article
- Article
- Clinical practice guidelines for the management of bipolar disorder: 2025 update.Indian journal of psychiatry · 2026Article
- Lithium prescription patterns for bipolar disorder at a psychiatric hospital in KwaZulu-Natal.The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa · 2026Article
- Article
- Lithium Point-of-Care Testing to Improve Adherence to Monitoring Guidelines and Quality of Maintenance Therapy: Protocol for a Randomised Feasibility Trial.Pharmaceuticals (Basel, Switzerland) · 2025Article
- Addressing the unmet needs of bipolar disorder in Australia and beyond.The Australian and New Zealand journal of psychiatry · 2025Article
- New Episodes and Suicidal Risks in Bipolar and Major Depressive Disorder Patients During Versus Before Long-Term Treatment With Lithium.Acta psychiatrica Scandinavica · 2025Article
- Brain Tumors, AI and Psychiatry: Predicting Tumor-Associated Psychiatric Syndromes with Machine Learning and Biomarkers.International journal of molecular sciences · 2025Review
- Prescribing lithium for the management of persons suffering from bipolar disorders: expert consensus based on a Delphi study.International journal of bipolar disorders · 2025Article
- Designing and characterizing first Iranian study evaluating serum levels of lithium in patients for population pharmacokinetics (FIRELOLIPOP): baseline and first report.Scientific reports · 2025Article
- Global Trends in the Use of Pharmacotherapy for the Treatment of Bipolar Disorder.Current psychiatry reports · 2025Review
- Subtherapeutic lithium supplementation causes physiological eccentric cardiac hypertrophy in young-adult wild-type male mice.Physiological reports · 2025Article
- Twenty-four years of prescription patterns in bipolar disorder inpatients with vs without lithium: a pharmacoepidemiological analysis of 8,707 cases in German-speaking countries.International journal of bipolar disorders · 2025Article
- Lifelong Pharmacoprophylaxis in Bipolar Disorder: Holy Grail or Hollow Promise?Indian journal of psychological medicine · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDuring over half a century, science has shown that lithium is the most efficacious treatment for bipolar disorder but despite this, its prescription has consistently declined internationally during recent decades to approximately 35% ever use or less of patients with bipolar disorder. CONTENT: This narrative review provides an overview of the decreasing use of lithium in bipolar disorder internationally, shortly summarises the evidence for lithium's acute and prophylactic effects in bipolar disorder, discuss the challenges in relation to lithium including side effects, long-term risks and myths around lithium and provides two detailed examples on how specialised care models may result in successful increase of the use of lithium to 70% of patients with bipolar disorder largescale and improve care regionally and nationally.
conclusionsDecades of scientific investigations and education and teaching of clinicians and the public has not increased the use of lithium on a population-based large scale. It is argued that lithium should be the drug of choice for maintenance therapy as the single first-line treatment and that organizational changes are needed with specialised care for bipolar disorder to systematically and long-term change the use of lithium on a large-scale population-level.
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.