There were 361 papers on lithium, published in 2023.

Today, we bring you the ones that inform our practice.

Welcome to the Carlyte Psychiatry podcast, keeping psychiatry honest since 2003.

I'm Chris Aiken, the editor-in-chief of the Carlat Psychiatry Report.

And I'm Kelly Newsom, a psychiatric MP, and a dedicated reader of every issue.

Lithium is the oldest psych med still in use.

And I mean old.

There are reports of its use in psychiatry, going back to the 1870s,

long before John Cade rediscovered it in 1949 from his hospital post in Melbourne, Australia.

My hometown.

But each year we learn more about this drug, and today we'll update you on the 2023 edition to the Lithium Library.

Our first papers deal with lithium's efficacy,

and here we have a significant update from the International Society of Bipolar Disorders.

In 2023, the Society released guidelines on the early course of treatment in bipolar 1 and bipolar 2 disorder.

In other words, which medications you should start first when you encounter a young person with a new diagnosis of bipolar disorder.

We see guidelines like this all the time, and they usually do little more than recite the list of FDA-approved options.

It's good bedtime reading if you have trouble falling asleep.

But this one woke me up.

They actually took a stand.

Here is what they said.

Quote, available evidence suggested that in the early course of the illness,

lithium use was associated with lower recurrence risk compared with other mood stabilizers.

...