Lithium in mood disorders – an update

Objectives.
The paper aims to present the most important clinical research on lithium in mood disorders, published between 2019 and 2023.

Literature review.
The bibliography was selected and discussed across such topics as prophylactic and therapeutic lithium efficacy in mood disorders, therapeutic lithium concentrations and preparations, advantages and adverse side effects of long-term lithium administration, clinical factors connected with the efficacy of long-term lithium administration, the use of lithium in pregnancy and the postpartum period, the prevalence of lithium use and attitudes of psychiatrists towards it, and the incentives for broader lithium administration.

Conclusions.
The studies at the turn of 2020s confirmed the significant role of lithium in preventing the recurrences of mood disorders and as a therapeutic drug in acute episodes of the illness. The potentiation of antidepressants in treatment-resistant depression may constitute the second indication for lithium administration after the prevention of bipolar disorder. The optimal lithium concentration for prophylactic purposes is 0.6–0.8 mmol/l. The most important among the advantages of long-term use of the drug are suicide prevention and a possible anti-dementia effect, but also a favourable effect on the functioning of many body systems. Adverse side effects of long-term lithium administration, including its influence on kidneys, can be minimised by appropriate application and drug monitoring. The use of lithium in pregnancy and the postpartum period seems relatively safe and therapeutically efficient. Despite the many advantages of the use of lithium in affective disorders, lithium is still underutilised, so that the therapeutic potential of the drug is not fully exploited.