Lithium in the living organism. Is an integrated hypothesis feasible?

Abstract

1. The effects of lithium on electrolyte metabolism can be demonstrated in man in acute as well as in long-term lithium treatment. No other lithium effects have been reproducible to a similar extent. 2. It seems feasible to integrate these lithium effects with effects on biogenic amines to form an integral hypothesis for lithium action in manic-melancholic man. 3. The results are consistent with one of the following two hypotheses: a) that lithium acts by membrane stabilization and/or b) that lithium acts by interplay with magnesium on one or more enzymes. 4. The above findings and hypotheses direct our attention to membrane dysfunction as the basic defect in manic-melancholic states. This may find support in our preliminary findings of special HL-A profiles in unipolar and bipolar manic-melancholic patients. 5. A four-type-pump-defect model to account for the various clinical types of affective disorders is proposed.