Bipolar disorder: A brief examination of lithium therapy

Address for correspondence: Dr. Abimbola Farinde Department of Pharmacy, Clear Lake Regional Medical Center, Webster, Texas, USA. E-mail: [email protected] Within the 21st century, bipolar I disorder (BD-I) has become a clinically significant and recognizable mental illness comparable to schizophrenia and depression but more evidenced based research is still needed to fully understand the mechanism of the disorder.[1] While bipolar disorder is becoming an increasing prevalent disorder in the general public, it can often be misdiagnosed with poor symptomatic and psychosocial outcomes even after treatment initiation.[1,2] The problem can lie in the fact that most bipolar patients can remain hidden for years unaware of their diagnosis or may be falsely diagnosed as suffering a similar or comparable mental illness.[2] There may be a significant delay between the first experience of symptoms and the initiation of symptoms which can be as long as 8–9 years.[3,4] The pristine presentation of the symptoms of bipolar disorder can be viewed as the exception rather than the rule due to the fact that the majority of patients can experience psychiatric comorbidity or one-third will experience rapid cycling at some point in their illness, thus providing a complex presentation and treatment.[5,6] Even though complex bipolar disorders are becoming increasingly more widespread, clinicians long relied on the description of symptom presentation as listed in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR).[6,7] The diagnosis of bipolar disorder should consist of a diagnostic differentiation using the combination of psychological, cognitive, and behavioral symptomatology and assessment of the clinical course of the illness.[8] The dramatic growth in the rate of bipolar disorder diagnosis during the last decade both in clinical and research setting has enhanced clinicians’ understanding of ways to provide effective and optimal therapeutic interventions for this lifelong affective disorder.[9]