Lithium therapy.

Affective (mood) disorders are common in all ages often chronic or recurrent, destructive of personal and social functioning with significant morbidity and mortality. Diagnosis still rests on the clinical skills of interview, observation and a knowledge of the disorders. Lithium is simple, cheap and effective although underused. It is the main pharmacological agent currently used in bipolar disorders and as an adjunct in other affective disorders. While it does have a narrow therapeutic window and can cause serious morbidity itself, it is safe when delivered properly reducing both morbidity and mortality. Lithium therapy should only be started in a specialist psychiatric setting but other clinicians will be involved either in maintenance treatment or in treating patients for separate disorders who happen also to be on lithium.