Lithium Carbonate is the treatment of choice for manic depressive (bipolar  
affective disorder), true -- but from what I know, it is much more effective as  
an anti-manic agent than in bringing the bipolar out of the depressive phase.  
This is not to lessen the treatment effects of LiCO3, it truly is remarkable  
what it does to BP AD clients.

BUT

In view of the long term studies, recent research seems to indicate that it may  
not be the "wonder drug" of the manic-depressives.  Long term, BP clients DO  
remit, even on maintenance doses of LiCO3.  In light of this fact, as well as  
the relative toxicity of Lithium, wouldn't the treatment choice for cyclothymia  
-- a more chronic, yet less unwieldy form of BP illness -- tend toward the  
psychotherapeutic end of the spectrum?  I would think that rather put a client  
on a rather toxic medication that may have questionable long term effects for a  
subtype of the illness that is typically long term, one might instead opt for a  
"symptom control" paradigm, where the client can learn to deal with the  
relative "low amplitude" swings of mood WITHOUT medication.

Comments?

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