Lithium was first used to treat depressive patients in the latter part of the 19th century, although the hypothesis upon which the therapy was based was actually incorrect. Therapeutic success was reported in a number of isolated cases.
The antimanic effect of lithium was discovered in 1949 and confirmed in a placebo-controlled, double-blind study in 1954.
During the 1960s lithium was found to prevent recurrences of both manic and depressive episodes. This prophylactic effect was first demonstrated in an open study using the mirror method, and subsequently (i.e. after 1970) confirmed in a number of double-blind, placebo-controlled discontinuation studies. Lithium prophylaxis was similarly efficacious in bipolar and unipolar patients.
An important historical event related to the safety and optimization of lithium prophylaxis occurred in the 1970s. Research emerged which indicated that long-term lithium use could possibly induce kidney damage. Through the exemplary joint efforts of many research teams, however, it was possible to rebut most of these alarming reports. Since the 1970s, researchers and physicians have recommended serum lithium levels slightly lower than those previously advocated.
An international multicenter study yielded strong evidence that mortality and suicide rates can be lowered by long-term lithium treatment – effects which have not been shown for any other long-term prophylactic treatment thus far.
