Introduction
When in 1949 Cade serendipitously discovered lithium as a potential drug for acute mania, it was a fundamental milestone in the development of psychiatric treatment. Until the early 1990 s lithium was in fact the only robust alternative to the use of typical anti psychotics for the treatment of acute mania. Early studies also suggested an acute efficacy of lithium in bipolar depression , and in the 1970 s lithium was established as the standard treatment in maintenance