Personalized aspect of lithium use in mood disorders

The knowledge of clinical and biological factors connected with lithium treatment and prophylaxis of mood disorders make an essential element of personalized treatment of these disorders. The most important indication for lithium use nowadays is the prophylaxis of manic and depressive recurrences in mood disorders. Such effect of lithium preventing affective recurrences is defined as “normothymic” or “mood-stabilizing”. The persons showing the very good prophylactic effect of lithium, so-called “excellent lithium responders” are characterized by distinct affective episodes with full remission between them, lack of psychiatric comorbidity and family history of bipolar mood disorder. In recent years, many other clinical and biological factors have been identified that made it possible to designate the best candidates for lithium prophylaxis. Among mood-stabilizing medications, lithium exerts the strongest anti-suicidal effect which should be considered an element of personalized management of mood disorders. Lithium is still a valuable drug for the treatment of acute episodes of mania and depression in the course of mood disorders and it augments the effect of antidepressant drugs in treatment-resistant depression. The latter seems as a second most important indication for lithium use and has been probably underutilized. Clinical and biological factors connected with lithium applications in these indications were presented which may contribute to the optimization of using lithium in such patients. The knowledge of the personalized lithium treatment in mood disorders can also concur to overcome the negative stereotypes connected with the drug and contribute to increasing the number of patients being the beneficiaries of lithium use.