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Janusz Rybakowski: Lithium – the amazing drug in psychiatry

Poznan: Termedia; 2020 (196 pages)

Reviewed by Janusz Rybakowski


INFORMATION ON CONTENTS: The book contains 25 chapters. Chapter 1 introduces the Kraepelinian classification of mental disorders and the author’s interest in lithium, dating back half a century ago.  Chapter 2 describes the lithium issue at the beginning of the world, antiquity, 19th century and the first half of the 20th century. Chapter 3 depicts the introduction of lithium into modern psychiatry by John Cade and the Australian lithium researchers during the 1940-50s. Chapter 4 is devoted to Mogens Schou, the undisputed leader of lithium therapy in the second part of the 20th century. Chapter 5 describes the clinical picture of unipolar and bipolar mood disorders. Chapter 6 presents medications used in mood disorders – antidepressants, antimanic drugs and mood stabilizers, of which lithium is the prototype. Chapter 7 illustrates what happens to lithium in the human body and what effect it has on biochemical processes. Chapter 8 is about commencing the use of lithium in mood disorders. Chapter 9 describes lithium’s efficacy in mania and depression, and its potentiation of antidepressants. Chapter 10 presents lithium as the optimal mood stabilizer for the prevention of recurrences of affective disorders. Chapter 11 shows the determinants of lithium’s prophylactic efficacy and the features of excellent lithium responders. Chapter 12 describes the adverse effects of lithium use and their management, and Chapter 13 examines the pharmacokinetic and pharmacodynamic interactions between lithium and other drugs. In Chapter 14, other mood stabilizers of the first and second generation and their relation to lithium are discussed. Chapter 15 describes the use of lithium in pregnancy and the postnatal period. In Chapter 16, evidence is presented for use of lithium as a suicide prevention drug, and in Chapter 17 as an antiviral and immunomodulatory drug. Chapter 18 describes the effect of lithium on cognitive functions and related factors. In Chapter 19, the evidence is presented for the neuroprotective effects of lithium that may qualify the drug for the use in neurodegenerative diseases, discussed in Chapter 20. In Chapter 21, other possibilities of using lithium in psychiatry and outside psychiatry are presented. Chapter 22 is dedicated to lithium textbooks, magazines and conferences as well as  lithium organizations such as the International Group for The Study of Lithium Treated Patients (IGSLI) and The International Consortium on Lithium Genetics (ConLiGen). In Chapter 23, lithium therapy in the context of literature and art is depicted. Chapter 24 is a subjective summary of the author’s “lithium path” and in Chapter 25, the prospects for the 70th anniversary of lithium in modern psychiatry are discussed. 


AUTHOR’S STATEMENT: The book is based on my half-century experience with lithium treatment. My enterprise with lithium started in 1970 and has been on going. I am the author of more than 150 papers indexed in PubMed on different aspects of lithium treatment. They include efficacy, side effects, neuropsychological, neurobiological and genetic determinants of such therapy. Recently we reported on five patients as being the excellent lithium responders, having received the drug for 40 years or more; this year I report on a patient with successful 50-year lithium administration.

During this time, I participated in most world-wide lithium-related events, such as British Lithium Congresses, multiple lithium conferences and, in the recent 20 years, the annual meetings of the IGSLI. I am one of the founders of the ConLiGen, aimed at performing the Genome-Wide Association Studies (GWAS) of lithium’s prophylactic response. My close friend of more than 30 years was Mogens Schou, the greatest lithium researcher of the 20th century. In 2018, I received the Mogens Schou Research Award at the conference of the International Society of Bipolar Disorder held in Mexico City.


November 12, 2020