Lithium has been used in the treatment of schizophrenic and schizoaffective disorders with inconclusive results. Interpretation of the results has been limited either by inadequate sample sizes or by the scarcity of adequately controlled trials. An additional problem in interpreting studies of the therapeutic use of lithium in schizoaffective disorders arises from the lack of universally accepted criteria for classifying such disorders at the time of the study.
In general, there are three prevailing opinions regarding the efficacy of lithium in schizophrenia: 1. Lithium is not effective in schizophrenia and may actually be deleterious because of the increased susceptibility of schizophrenics to lithium-induced CNS toxicity.1-3 2. Schizophrenic patients who respond to lithium treatment are in reality "atypical" manic-depressives. Since severe mania may mimic schizophrenia (including appearance of first-rank Schneiderian symptoms), a favorable response to lithium indicates a need for rediagnosis.4-6 3. There is a subgroup of "pure"
Prien RJ. Lithium in the Treatment of Schizophrenia and Schizoaffective Disorders. Arch Gen Psychiatry. 1979;36(8):852–853. doi:10.1001/archpsyc.1979.01780080026007
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