Cerebrospinal Fluid Lithium in Manic Illness

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Abstract
The lithium ion has been found increasingly valuable in the treatment of manic illness (1, 2). In the therapeutic use of lithium there are two phases, stabilization and maintenance. These data have been reviewed by Gershon and Yuwiler (1), but a clear explanation of the pharmacodynamics involved is not evident. Animal experimentation has been used to study the behaviour of the lithium ion as compared with other cations. The lithium ion's behaviour resembles sodium in some tissues and enzyme systems but is more like potassium in others. These authors have reported a three- to fourfold increase in the tolerance for toxic symptoms due to lithium ion in manic patients as compared to normals. They found that this increased tolerance decreased to normal as the patient's manic state subsided.

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