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Despite increasing scientific interest, relatively few patients with bipolar disorder receive lithium therapy. Lithium is the only drug that is effective in the prophylaxis of manic, depressive, and suicidal symptoms. Lithium therapy is also associated with a variety of adverse drug reactions and the need for therapeutic drug monitoring. Numerous studies have focussed on the efficacy and safety of both lithium-monotherapy and lithium-add-on therapy. The aim of this study is to provide a systematic overview of clinical\u00a0studies on lithium therapy for bipolar disorder from the last 7 years and to present a critical analysis of these studies. The results provide an up-to-date overview of the efficacy, tolerability, and safety of lithium therapy for bipolar disorder and thus improve the pharmacotherapy of bipolar disorder. A total of 59 studies were analysed using various analysis parameters. The studies were also categorised into different subgroups. These are lithium-monotherapy, lithium vs. placebo\/drug, and lithium + adjunctive therapy. The majority of the studies (<jats:italic>N<\/jats:italic> = 20) had a duration of only 3\u20138 weeks. Only 13 studies lasted for &gt; 40 weeks. Lithium was superior to aripiprazole, valproic acid, and quetiapine in terms of improving manic symptoms. Lithium therapy resulted in a lower relapse rate compared to valproic acid therapy. Lithium was more neuroprotectively effective than quetiapine. Fourteen of the 22 add-on therapies to lithium showed a predominantly positive effect on the treatment outcome compared to lithium-monotherapy. Only the add-on therapy with sertraline led to a higher rate of study discontinuations than lithium-monotherapy. Lithium is a safe and effective treatment option for children. However, risperidone and quetiapine were superior to lithium in some aspects, which is why these drugs should be considered as an alternative treatment option for children. Collectively, current clinical studies highlight the relevance of lithium in the treatment of bipolar disorder.<\/jats:p>","DOI":"10.1007\/s00210-024-03210-8","type":"journal-article","created":{"date-parts":[[2024,6,25]],"date-time":"2024-06-25T14:02:08Z","timestamp":1719324128000},"page":"9723-9743","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Lithium, the gold standard drug for bipolar disorder: analysis of current clinical studies"],"prefix":"10.1007","volume":"397","author":[{"given":"Magdalena","family":"Airainer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland","family":"Seifert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,6,25]]},"reference":[{"key":"3210_CR1","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1016\/j.jpsychires.2021.12.035","volume":"146","author":"M Ahmadpanah","year":"2022","unstructured":"Ahmadpanah M, Pezeshki R, Soltanian AR, Jahangard L, D\u00fcrsteler KM, Keshavarzi A, Brand S (2022) Influence of adjuvant clonidine on mania, sleep disturbances and cognitive performance - results from a double-blind and placebo-controlled randomized study in individuals with bipolar I disorder during their manic phase. 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