Wednesday, 28.10.2020

 

Thomas A.Ban, editor. Lithium in Psychiatry in Historical Perspective.

Antonio Torres-Ruiz’s comment

Introduction of Lithium in Mexico

 

       In the 1960s, and more specifically in 1967, I started my medical residency in psychiatry at the National Institute of Neurology and Neurosurgery (INN), where I met Dr. Dionisio Nieto Gómez, head of the Department of Psychiatry, who had initiated the use of lithium on manic-depressive psychosis in Mexico. He introduced it in 1960, and publicly communicated it for the first time in 1963, in an article entitled "Treatment of Mania with Lithium Carbonate.”

       It is of interest to note that an important discovery was made by the Australian
psychiatrist John Cade in 1949. He observed that lithium had very favorable effects on mania, observations confirmed by Noack and Trautner in 1951. However, systematic employment was promoted by Mogens Schou and his collaborators in Denmark from 1954. Lithium represented a true revolution in psychiatric therapy that also opened new horizons for the investigation of affective disorders. The accurate observation by Schou and other authors that lithium acts as a prophylactic for manic and depressive outbreaks represented an extraordinary step in psychiatric therapy. In 1969, in the journal Neurology-Neurosurgery-Psychiatry, another article by Doctor Nieto was published, entitled "Lithium in Manic-Depressive Psychosis."

       The findings of the use of lithium in affective disorders were made public in the 1960s and became widely known in different parts of the Americas. During that time, we were using lithium carbonate in 250 mg capsules, which we ordered as magisterial prescriptions to be prepared in special pharmacies that were able to manufacture them, such as the Valdecasas laboratory in Mexico City. Occasionally, people came to us from other countries, since lithium carbonate did not exist their patent pharmacy until it was approved and used regularly.

       We routinely requested serum dosing to maintain lithium levels between 0.5 and 1.2 mEq per liter and retained control over the renal and thyroid functioning. Thus, it was Doctor Dionisio Nieto Gómez and his group of assistants who used lithium carbonate for the first time, as far as we know, in the management of manic-depressive psychosis and in America.

 

References:

Cade JFJ. Lithium salts in the treatment of psychotic excitement. Med J.Aust. 1949, 2:349-352.

Nieto D. Tratamiento De la manía con carbonato de litio (Treatment of Mania with Lithium
Carbonate). Neurología, Neurocirugía, Psiquiatría 1963; 4:123-4.

Nieto D. El litio en la psicosis maníaco depresiva (Lithium in Manic-Depressive Psychosis). Neurología, Neurocirugía, Psiquiatría.1969; 10:63-72.

Noack D, Trautner EM. The lithium treatment of maniacal psychosis. Med J Austr 1951; 2: 218-22.

 

July 2, 2020