Some current thoughts on lithium carbonate in manic-depressive illness based on a double-blind comparison with chlorpromazine.

Reviewed data gathered in a double-blind study comparing 8 lithium patients and 8 chlorpromazine patients, originally published in 1970 and then continued, together with the author's general experience with lithium. It is concluded, that lithium is not significantly superior to chlorpromazine in acute mania and that in severe manias chloropromazine or possibly a combination of chlorpromazine and lithium is more effective. For prophylaxis the combination of lithium plus tricyclic antidepressants in manic-depressive illness circular type is suggested. The lithium induced delirium is discussed as a specific side effect in severe manias. A case of gastrointestinal flu leading to severe lithium intoxication is also described.