Lithium has a venerable history in medicine, and lithium salts were fully accepted into psychiatry's armamentarium after John Cade's seminal report of 1949. The efficacy of lithium as a treatment for mood disorders (both bipolar and unipolar), as shown in meta-analyses of clinical trials, is robust, and worrisome adverse effects, such as renal failure, can be strikingly reduced with careful monitoring. However, paradoxically, as evidence of lithium's efficacy has accumulated, its use has declined....
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