Lithium Therapy: a personal tale of the recent decade

Lithium is a first choice mood-stabilizer for the maintenance treatment of bipolar disorder. The drug can augment antidepressants in treatment-resistant depression and exerts anti-suicidal, immunomodulatory, and neuroprotective action. For the author of this book, clinical use and mechanism of therapeutic action of lithium have been a leitmotiv since 1970. It resulted in multiple publications, and the book “Lithium – the amazing drug in psychiatry”, published in 2020. Thirty-nine papers from the recent decade were selected here, in all of them Prof. Rybakowski is the first or the last author.
The editorial in Neuropsychobiology on the 60th anniversary of lithium entering modern psychiatry is followed by the 2010 update on lithium in neuropsychiatry. The studies of an association between lithium efficacy and temperament as well as candidate genes are presented. The effects of lithium on cognitive, kidney, and thyroid functions were covered in many articles. The studies on lithium’s biochemical mechanism with very small embryonic-like stem cells and mRNA of neuronal and glial markers are shown.
Ultra-long-term therapy with lithium is described in five patients receiving lithium for more than 40 years, and in another paper, presenting a patient on lithium for half a century. Given the clinical and biological properties of lithium, this drug is presently greatly underutilized and efforts should be undertaken for challenging lithium’s skepticism and optimizing its long-term administration. Such a message was expressed in a special paper published in 2018 and in several “state of the art” papers on lithium in 2020.

About the Author:
Prof. Janusz K. Rybakowski was the Head, Department of Adult Psychiatry, Poznan University of Medical Sciences, 1995-2016, the Chairman, Department of Psychiatry, Medical Academy, Bydgoszcz, 1985-1995, the NIH Fogarty Research Fellow, University of Pennsylvania, Philadelphia, 1976-1977. He was the President of the Polish Psychiatric Association, 1998-2001. Authored over 700 scientific articles, Hirsch Index 56, and the books “The Faces of Manic-Depressive Illness” (2009) and “Lithium – the Amazing Drug in Psychiatry” (2020). A member of the Editorial Board of 16 international journals. In 2012, received the Lifetime Achievement Award of the European Bipolar Forum, in 2015, the Lifetime Achievement Award in Biological Psychiatry of the World Federation of the Societies of Biological Psychiatry, and 2018, the Mogens Schou scientific award of the International Society of Bipolar Disorders.