Lithium and bipolar disorder

Professor James Potash discusses two hypotheses on how lithium, which has been successfully used to treat bipolar disorder for many years, may affect the brain.

Lithium has been around since 1949; it’s the best medicine to use for treating bipolar disorder. It is also potentially a window into how the illness unfolds in the brain. It has been known for about 20 years now that lithium works on the myo-inositol pathway in neurons, and it’s still not entirely clear if that is the main mechanism of action. There is now another hypothesis that lithium may work, in part, through the Wnt signaling pathway. That has lead a number of groups to try to understand better whether those two pathways are key to the illness; our group actually just published a paper this month in the Archives of General Psychiatry showing that Wnt signaling genes may be implicated in bipolar disorder.