Barry Blackwell:  Risks and Relevance of Lithium - Barry Blackwell’s reply to Gordon Johnson’s comment

Gordon Johnson’s comments are affirmative and informative, correctly identified as “an educational and training issue”, and coupled with wise and detailed advice culled from long experience.

How to disseminate this kind of advice to those who prescribe lithium but do not follow such guidelines, including primary care practitioners and specialists as well as psychiatrists, is a dilemma.  It underlines concern that a prestigious, widely read journal, such as JAMA could overlook this aspect to focus instead on an unsubstantiated claim of “over prescribing”. Lithium is highly effective, specific and cost effective for a disruptive disorder that can ruin and sometimes end the lives of its often highly productive victims.

An attempt to question the accuracy of the Journal’s conclusion was never shared with their author but received a cavalier dismissal from a group of sub-editors who voted it “lacked significance”. One might conclude they were more concerned with protecting their pharmaceutical advertising revenue and the scientific integrity of a published but flawed conclusion.

Barry Blackwell

October 29, 2015