Strengths:

• 'Gold standard' of mood-stabilizing drugs
• Well-documented efficacy in acute mania and maintenance (less so for bipolar depression)
• Documented antisuicidal effects
• Has been used for more than 50 years
• Inexpensive
  

Weaknesses:

• Narrow therapeutic index
• Difficult to use (monitoring of plasma concentration is required)
• Poor tolerability profile
• Poor compliance which may lead to premature relapse
• Predominantly effective against manic relapse

GSK counterclaim:

Lithium is less effective in treating depression compared with mania (Calabrese JR et al. and Bowden CH et al.).

Guidelines

Supporting trials