Bipolar Medication: Lithium

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Lithium belongs to the drug class: antimanic agents and it is sold under the US brand names:

Lithobid, Eskalith, Eskalith-CR. More than 5.7 million American adults or 2.6 percent of the

population age 18 or older in any given year have bipolar disorder. Lithium is helping some of

this American. It has become one of the first and widely used psychiatric drugs for the

treatment of bipolar disorder in the United States, since its approval in the 1970s. It also has

become one of the most studied psychiatric medications.

Indication:

Lithium is an effective drug for bipolar disorder as its properties help to prevent, as well as

stabilize, manic-depressive mood swings that occur in this psychiatric condition. By controlling

mood disorder, it also reduces the risk of suicide. This is an advantage of lithium that is lacking

in some other drugs. But it is more effective in preventing depression than it is in preventing

mania. However, it needs time to develop and reach its ideal therapeutic level in the body

before it induces any effects. Usually it takes about 1-3 weeks, however, in the case of sudden

or acute bipolar episodes, if lithium hasn’t reached its optimum level in the client’s body, it can

be prescribed along with other medications for effectiveness.

Lithium can also be prescribed for other psychiatric disorders besides bipolar disorder. It can be

useful when other drugs fail in conditions such as schizophrenia, major depression, and certain

psychiatric problems in children.

Mechanism of Action:

Although lithium had been used for more than 50 years in the treatment of bipolar

disorder, its mechanism of action was unknown; until 1998. Scientists didn’t know the cause of

mood swings in bipolar disorder either. A study made in 1998, by a group of researchers from

Wisconsin University shed light on how lithium works and why it is effective. It was concluded

that lithium acts on certain nerve cells in the brain and the receptors of the neurotransmitter

glutamate. Lithium has a dual effect on these receptors, and using this, it helps to regulate the

level of glutamate between cells, preventing it from reaching too high or too low concentrations.

According to the director of this research, Dr. Lowell Hokin, who is also a school

professor of pharmacology at Wisconsin University; too little glutamate between neurons cause

depression, while excessive amounts of glutamate cause mania. But it is also believed that

there are more causes and factors involved in these disorders besides the level of glutamate,

but nevertheless, the study has been very helpful as it has uncovered the fundamental causes

of bipolar disorder."

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