In the late 1800’s, the German psychiatrist Emil Kraepelin was unhappy with the primitive state of psychiatric diagnosis. So he set up shop at the Heidelberg Clinic and proceeded to study hundreds of patients longitudinally.

Suddenly, it seems that everybody and their cousin is asking us if they have bipolar disorder. A few years ago, bipolar disorder was the ignored orphan diagnosis in psychiatry. However, now that various patented molecules have been proven effective, industry money is flying into efforts to publicize the diagnosis, and it's clearly working.

It's an amazing metal. Not only does it treat acute mania, prevent recurrences, and treat refractory depression, but when consumed as LiCl, it tastes pretty good on vegetables. Or at least it did before the 1950s, when it was dropped from the list of acceptable salt-substitutes for hypertensives because of a nasty tendency to cause toxicity.

First thing's first. What's the deal with all the confusing names for Depakote? The basic, irreducible molecule here is valproic acid, also known as valproate, and the brand name of this is "Depakene", not Depakote.

Dr. Ghaemi, I thought we could discuss this rather controversial issue of whether antidepressants (ADs) should be prescribed in bipolar disorder, particularly in light of the recent article published in the American Journal of Psychiatry by Altshuler et. al. (1).

The discovery of the therapeutic effects of lithium is one of the most fabulous examples of serendipity in all of science. In 1949, John Cade was a 37 year old superintendent of a psychiatric hospital in the Australian outback.

Dr. Carol Edelstein is a psychiatrist in private practice in Los Angeles, California, and has a particular interest in eating disorders. She describes a case below that falls in that vague hinterland between cyclothymia and bipolar disorder, type II.

We apologize in advance. But it was inevitable that TCR would eventually have to tackle what may be the most boring topic in all of psychiatry, if not medicine in general: Drug-drug interactions.

Drug interactions are enormously complicated. In tried and true TCR fashion, I have tried to make this topic easier to stomach. Nonetheless, you can skip this article if you make a decision to avoid prescribing the following medications ...

When it comes to Lithium, you can (thankfully) forget all about the P450 enzymes, because they don't touch this salt. Lithium enters the bloodstream, accomplishes its mysterious mood-stabilizing duties, and then is simply whisked out of the body intact by the kidneys via urine. So with Lithium, it's all about kidneys.