In 1949 Cade1 introduced lithium into psychiatric use in Australia demonstrating its efficacy in the treatment of manic excitement. Unfortunately the drug almost immediately acquired a sinister reputation in the United States when its use as a salt substitute in cardiac patients caused a number of deaths from lithium poisoning.2 In Europe the advent of chlorpromazine and reserpine in the early 1950’s delayed the development of lithium; but in the last few years interest has revived as knowledge of fluid balance and mineral metabolism in affective disorders has increased.3
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