Feature Articles 

Lithium: Underappreciated and Underused?

Robert H. Howland, MD


At the universe’s origin, the only chemical elements created with the “Big Bang” were hydrogen, helium, and lithium. Lithium, the third element of the periodic table, is ubiquitous throughout our environment, and trace amounts are present in our diet. Although lithium batteries power many electronic gadgets, lithium compounds dampen the energetic highs of patients experiencing bipolar disorder. Yet, how a naturally occurring chemical element such as lithium is an effective treatment for bipolar disorder remains a mystery. Many trace elements are known to influence various biological processes and are essential for human health. Although it has been hypothesized that lithium may be an essential trace element for humans, and studies in rats and goats suggest it may be an essential dietary nutrient, the natural or essential role of lithium in human beings remains uncertain. In this article, the history of lithium and some important aspects of its clinical use are reviewed.


Robert H. Howland, MD, is Associate Professor of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania.

Address correspondence to: Robert H. Howland, MD, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, 3811 O’Hara Street, Pittsburgh, PA 15213; e-mail: HowlandRH@upmc.edu.

Dr. Howland has disclosed no relevant financial relationships.


  1. Discuss the history of lithium’s therapeutic use in psychiatry.
  2. Describe some of the therapeutic uses of lithium in psychiatry.
  3. Explain the biological effects of lithium on the central nervous system.


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