IN 1949, Cade in Australia1 reported the surprising discovery that lithium salts being used to substitute for sodium salts in cardiac disorders, seemed efficacious in treating acute affective disorders of the manic-depressive type. This finding was subsequently confirmed by Schou in Denmark,2 Hartigan in England,3 and Schlagenhauf et al4,5 in the United States. Lithium appears equally efficacious in acute disorders and as a prophylactic agent to prevent or minimize recurrence of manic or depressive episodes in manic depressives.6-9 Results in recurrent depressions are not clear-cut; Baastrup and Schou6 report positive results; Schlagenhauf et al5 give negative results. Results in schizophrenia are usually negative.9
While the literature uniformly reports positive results in the acute and chronic treatment of manic disorder with lithium, the drug has not yet been completely accepted, probably because of early reports of lithium toxicity in