Below is a summary of what patients with bipolar need to know about lithium.

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Multiple assets of lithium beyond its anti-manic effects that patients should consider.

Variable: Data

Diagnosis: Lithium prevents unipolar and bipolar depression.

Suicide: Lithium prevents suicides in patients and in the general population.

Suicide: Lithium prevents suicide in the general population at minuscule doses in the water supply.

Augmentation: Lithium enhances the effects of other mood stabilizers and atypical antipsychotics.

Hippocampus: Lithium increases the volume of the hippocampus.

Gray/white matter: Lithium prevents or reverses cortical gray matter and white matter tract deficits.

Circadian rhythm: Lithium normalizes circadian rhythm abnormalities and has immune-modulating effects.

Immune system: Lithium has immune-modulating effects.

Telomeres: Lithium increases the length of telomeres shortened by episodes, stress, and aging.

Memory: Lithium prevents or slows memory deterioration in mild cognitive impairment over one year.

Dementia: Lithium reduces the incidence of a diagnosis of dementia in old age.

Life expectancy: Lithium prolongs life expectancy and reduces the incidence of all-cause mortality.

All-cause mortality:  Lithium reduces the incidence of all-cause mortality

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Lithium is the superior first-line treatment for bipolar disorder (BD). Yet the percentage of patients receiving lithium is abysmally low, especially in the US. Since psychiatrists have failed to place lithium in its appropriate role, we make the case that patients with BD themselves need to be better educated about the unique characteristics and preeminence of the drug so that it can be used more often and appropriately. Lithium has a highly unfavorable popular reputation among would-be patients and many psychiatrists. Thus, a direct appeal to patients with BD appears appropriate to try to remediate this situation. The unique assets of lithium are underappreciated or not well known. Conversely, the side effects profile of lithium are overestimated. Here, we make the case that lithium’s image needs to be revised not only with better and more accurate information but also with a wholesale renaming and rebranding of the drug. We will not only outline the unique qualities and new information about the side effects of the drug but attempt to change some of the terminology conventionally used to refer to lithium so that its use may be appropriately applied earlier and at an increased frequency for patients with BD.

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This is from the full article in: Pharmaceuticals (Basel). 2024 Sep 17;17(9):1223. doi: 10.3390/ph17091223