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The use of lithium in mixed states

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Lithium is a unique drug. In more than60 years of observation, it showed its multiple important clinical properties in treating mania, stabilizing mood alterations, preventing suicide and protecting from neurodegeneration. It was also the most extensively studied drug in psychiatry. Nevertheless, it is generally underprescribed. Specifically, lithium is virtually not considered in the treatment of patients affected by mixed affective states. Lithium is not suggested for the acute treatment of mixed affective states and is considered tobeless effective than other mood stabilizers in the long-term management ofthese patients. The main reasonwhylithium has no indication for mixed states is the “lack of evidence.” Actually, there are several reasons to consider lithium as an effective treatment in patients with mixed affective states.
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