Lithium - the benefits of long-term treatment.

In their editorial, Malhi et al1 advocate the more frequent use of lithium in patients with mood disorders which concurs with my appeal voiced two years ago2 . Lithium has been universally accepted as the first choice mood-stabilizer for maintenance treatment of bipolar disorder and exerts also anti-suicidal, immunomodulatory, and neuroprotective action. However, the use of lithium in mood disorders has been greatly underutilized, due to the introduction and promoting other mood-stabilizers both first-generation (e.g. valproate) and second-generation (e.g. olanzapine, quetiapine, lamotrigine), and perception of lithium as a "toxic drug" not only be the non-psychiatrist physicians but also by the representatives of mainstream psychiatry, pointing to its side effects, mainly thyroid, renal and cognitive ones.