In the 1950s, Mogan Shoe was fresh out of residency training.

He staked his career and his family on a mineral most of his colleagues dismissed as dangerous nonsense.

This is the story of how lithium went from a fringe wellness fad to the gold standard for bipolar disorder

and the bitter scientific battle that nearly derailed it.

Welcome. and the bitter scientific battle that nearly derailed it. Welcome to the Carlet Psychiatry Podcast, keeping psychiatry honest since 2003.

I'm Chrisake and the editor-in-chief of the Carlet Psychiatry Report.

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

But first, a correction. I've realized we've pronounced Dr. Scho's name incorrectly on this podcast at times.

The correct pronunciation is Moen's Scho. There's a silent G in Moen.

The year is 1951. Mogan's shoe has just read a report on 10 patients whose mania resolved with lithium. The young Danish psychiatrist had enrolled in

medical school hoping to find a way to treat mood disorders, inspired in part by his brother's experience with

recurrent depression. Dr. Shue's father, himself a prominent psychiatrist, had delivered

pointed lectures dismissing lithium as a useless fad built on an erroneous theory. But his father's

generation had not discovered anything else for

mania. Antipsychotics were still a few years away. Shoe figured lithium was worthy of

further investigation, and he knew of a new method to test it, randomization. Three years earlier,

Austin Bradford Hill had published the first randomized controlled trial,

a 1948 study of streptomycin and tuberculosis.

But no one had taken randomization to psychiatry, and Shu decided to change that.

Using a coin flip, he randomly allocated 38 manic patients to lithium or placebo.

After two weeks, lithium worked, surpassing placebo on a crew to three-point scale of mania.

And then Schu noticed something else in the data that still holds up as one of the most

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