The first chapter (HERE) of our investigation into lithium looked at the role Australian scientist John Cade played in establishing lithium salts as the gold standard of psychiatric care for bipolar disorder from the 1950’s onward.
Our second chapter (HERE) examined exactly what lithium is, where it comes from and it’s myriad of diverse uses.
Today’s look-see will explore the history of lithium within the world of psychiatric care and answer the question “Was Australian scientist John Cade really the first to bring lithium use for mental care to the masses?” Seriously.
Tracing the history of lithium therapy is a little bit like trying to pinpoint the man who ate the first oyster. Lithium has been in medical use—including psychiatric use—since at least as far back as ancient Greek and Roman times.
Back in this era, people suffering from melancholia or mania would be soaked in alkali-rich mineral springs to soothe their conditions. Many mineral springs contain lithium, among other elements, and some of them such as Mineral Wells in Texas, even today have age-old reputations as “crazy waters”.
To understand how lithium entered medicine in more recent times we have to go back to the mid-nineteenth century when it was introduced -mistakenly as we now know – for the treatment of gout (a type of arthritis). Back then a commonly subscribed to theory was that recurrent episodes of gout could lead to mania and melancholia – ‘brain gout’, if you will. Lithium was viewed as a treatment to heal these states as well.
In 1871, American military physician William Hammond reported using lithium bromide in the treatment of mania. But nothing further came from it. Around the same time, two Danish doctors, brothers Carl and Fritz Lang, began treating recurring depression with lithium. However because publication of their work was in Danish and German it restricted their audience and their approach fell into disuse.
Slowly however lithium began to be seen as a general ‘pick-me-up’ tonic. It was praised for its supposed magical healing powers and considered useful in helping to manage everything from hemorrhoids, paralysis and constipation to diabetes, eczema, gallstones and kidney trouble.
Lithium beer was brewed and marketed in U.S. Wisconsin. In 1929, in the weeks before the Wall Street stock market crash, the popular soft drink 7-Up was launched, boasting lithium as an ingredient. There was even a lithium version of Coca-cola. At this time lithium was not regarded as a drug, but as a health-promoting dietary supplement. In the 1940’s Americans didn’t need a prescription to get lithium; all they had to do was walk into a health food store and ask for it.
Even the science-fiction writer H.G.Wells (1866 – 1946) included lithium and it’s calming restorative powers in a short story he wrote called THE RECONCILIATION. Lithium water stirred with whisky was a gentleman’s balm to settle unsteady heads introduced when the two central characters, both scientists, have a heated disagreement.
Yet lithium failed to develop the foothold in the medical world afforded other substance remedies. It’s fair to say the overwhelmingly vast majority of other medications in psychiatry, indeed the whole of medicine, are discovered and promoted with hefty pharmaceutical company support.
A patent is taken out, and, if all goes well, millions of dollars are scooped up by investors. But not for plain old lithium; dug from the earth, no one owned the patent but mother nature; elements on the periodic table can’t be patented. It therefore meant that no pharmaceutical company contorted itself to promote and push lithium hard in the marketplace at this time.
By the time John Cade was performing his experiments on guinea pigs in the late 1940’s however, lithium as a treatment for serious depression and schizophrenia had fallen out of favour and been superseded by other types of psychiatric therapy treatment, including the barbaric-by-today’s- standards insulin coma therapy.
It is therefore entirely accurate to conclude the role Australian scientist John Cade played in bringing lithium to the forefront of psychiatric treatment for the mentally ill from the 1960’s onward was NOT DISCOVERING lithium but RE-DISCOVERING it.
Gradually, after dosages approached uniformity and careful monitoring became routine, lithium in various compounds was recognized as an acceptable treatment for those suffering manic depression, or what is now known as bi-polar disorder.
Lithium gluconate was approved in France in 1961, lithium carbonate in Britain in 1966, lithium acetate in Germany in 1967 and lithium glutamate in Italy in 1969. In 1970, after passing the strict controls and approvals process imposed by the FDA (Food & Drug Administration) the United States became the 50th country to admit lithium to the pharmaceutical marketplace.
** Attribution ** A total of eleven different information sources were consulted for the writing of this article, including the 2016 published book FINDING SANITY which I read cover to cover last year.
** Next week, in our final installment, we take a look at Australian scientist John Cade’s very first lithium patient. Bill Brand has been described as the ‘single most important patient in Australian psychiatric history‘. His story is indeed a fascinating one.