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Therefore, a review of this evidence is timely. The efficacy of lithium as an acute treatment and as a maintenance treatment of bipolar disorder was evaluated through a review of the evidence, focusing on modern, randomized, parallel\u2010group designed trials. Additionally, the evidence was sought translated into the proper use of lithium in clinical practice. Lithium's antimanic efficacy has been convincingly demonstrated. However, as blood monitoring due to the risk of toxicity is required and due to an insufficient response in highly agitated patients, lithium monotherapy has a limited place in the acute treatment of severe manic states. For acute bipolar depression, results are conflicting. Recent maintenance trials have added substantially to the documentation of lithium's long\u2010term stabilizing properties in bipolar disorder, and these properties have been demonstrated independently of any acute response to lithium. Finally, it is now beyond doubt that not only does lithium prevent mania, but also depression in bipolar disorder. Lithium is still to be considered a major if not the most important mood\u2010 stabilizer, at least for maintaining long\u2010term stability in patients with bipolar disorder. The potential risks of lithium should be weighed up against its benefits and the fact that serious adverse effects are usually avoidable.<\/jats:p>","DOI":"10.1111\/j.1755-5949.2011.00260.x","type":"journal-article","created":{"date-parts":[[2011,6,25]],"date-time":"2011-06-25T22:13:18Z","timestamp":1309039998000},"page":"219-226","source":"Crossref","is-referenced-by-count":141,"title":["Lithium: Still a Major Option in the Management of Bipolar Disorder"],"prefix":"10.1111","volume":"18","author":[{"given":"Rasmus W.","family":"Licht","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2011,6,23]]},"reference":[{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.1949.tb36912.x"},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1998.tb10020.x"},{"key":"e_1_2_9_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/00004714-199312000-00005"},{"key":"e_1_2_9_5_2","volume-title":"Manic\u2010depressive illness","author":"Goodwin FK","year":"1990"},{"key":"e_1_2_9_6_2","first-page":"269","article-title":"The anti\u2010aggressive actions of lithium","volume":"4","author":"Nilsson A","year":"1993","journal-title":"Rev Contemp Pharmacother"},{"key":"e_1_2_9_7_2","first-page":"179","volume-title":"Lithium in Neuropsychiatry. 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