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July 20, 1979

Lithium in the Treatment of Mania: Comparisons With Neuroleptics

Author Affiliations

From the Clinical Psychobiology Branch, National Institute of Mental Health, Bethesda, Md.

Arch Gen Psychiatry. 1979;36(8):840-844. doi:10.1001/archpsyc.1979.01780080014003

Since the original discovery of the antimanic properties of lithium nearly 30 years ago,1 a large number of studies, as well as extensive clinical experience, have confirmed the efficacy of this drug for the treatment of the manic phase of manic-depressive illness. The recent focus of questions concerning the role of lithium in the treatment of mania has shifted from efficacy per se to comparisons with other drug treatments and the related issue of specificity. This review will, therefore, focus on controlled studies comparing lithium with neuroleptics, following a brief historical review of the earlier studies. The studies comparing lithium with neuroleptics are of special importance not only from a practical point of view but also theoretically, in that they bear on the question of the specificity of lithium against the manic syndrome—a question with implication for the underlying pathophysiology of mania.

OPEN SINGLE-BLIND STUDIES  Table 1 summarizes the