Lithium has long been established as a first-line mood stabilizer in the treatment of bipolar disorder and treatment-resistant depression. In addition to its psychiatric applications, lithium has demonstrated neuroprotective properties through its influence on neurotransmitter regulation, neuroplasticity, inflammation, and oxidative stress. Objective: This narrative review aims to provide a comprehensive analysis of lithium’s role in mental health, focusing on its clinical efficacy, underlying neurobiological mechanisms, and expanding therapeutic applications. The review also addresses safety considerations and explores innovative strategies to optimize lithium use in contemporary psychiatry. Methods: A systematic literature search was conducted in PubMed (MEDLINE) and the Virtual Health Library (BVS), covering publications from January 2000 to December 2024. Inclusion criteria comprised peer-reviewed original studies, systematic reviews, meta-analyses, and randomized clinical trials published in English, Portuguese, or Spanish. A total of 68 articles were selected following title and abstract screening and full-text analysis. These articles explored lithium’s clinical effects, mechanisms of action, safety profile, and emerging applications. Results: Lithium remains the gold standard for managing bipolar disorder, with strong evidence supporting its efficacy in mood stabilization and suicide prevention. Emerging data also support its use in major depressive disorder, schizoaffective disorder, and neurodegenerative conditions such as Alzheimer’s and Parkinson’s disease. However, its narrow therapeutic index necessitates close monitoring due to risks of renal, thyroid, and metabolic dysfunction. Recent advances in pharmacogenomics, sustained-release delivery systems, and microdosing approaches offer new avenues to enhance therapeutic efficacy while reducing adverse effects. Conclusion: Lithium continues to play a pivotal role in psychiatric treatment and is gaining relevance in neuroprotective strategies. Future research should prioritize the identification of predictive biomarkers, refinement of dosing strategies, and the development of personalized approaches to maximize benefits and ensure safe, long-term use.
Cite this paper
Cruvinel, I. D. , Zanuzzi, T. R. L. and Oliveira, F. M. D. (2025). Lithium and Mental Health: The Small Element with a Big Impact. Open Access Library Journal, 12, e3282. doi: http://dx.doi.org/10.4236/oalib.1113282.
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