Objective: Overview and discussion regarding the use and relevance of lithium as an therapeutic agent for bipolar disorder in general, with a special focus on pregnancy, suicidality and possible side-effects.
Method: Literature was handsearched and by searches of medline with special interest in recent results and comparative studies.
Results: Lithium is still of high importance in the treatment of bipolar disorder. It is unmatched regarding decades of clinical experience and scientific evidence. It has a proven efficacy in every spectrum of bipolar illness, with less profound data regarding acute bipolar depression. Especially long term treatment of bipolar patients with lithium shows clear clinical benefits i.e.: importance of a continuous setting, gain of mood stabilizing effect over time, no loss of efficacy, reduced morbidity and mortality.
Discussion: Lithium should be regarded as a first line treatment for bipolar disorder.