2018 issue 2


Volume 34, issue 2

Original article

The use of lithium in Poland in 2004–2017

Janusz Rybakowski1, Katarzyna Chęcińska2
1. Klinika Psychiatrii Dorosłych, Uniwersytet Medyczny w Poznaniu
2. Adamed Pharma
Farmakoterapia w Psychiatrii i Neurologii 2018, 34 (2), 85–94
Date of publication: 04-09-2018
DOI: http://dx.medra.org/10.17393/fpn.2018.07.003
Keywords: bipolar disorder, lithium, mood stabilising drugs


Objectives. Lithium is the first choice drug for the prophylaxis of recurrences in bipolar disorder (BPD). Besides mood-stabilising activity, it exerts antisuicidal, immunomodulatory and neuroprotective effects. However, the drug is greatly underutilised, due to a promotion of other mood-stabilising drugs, both 1st and 2nd generation, and to exaggerated concerns about lithium toxicity. This has been reflected in many countries by a decrease of lithium prescriptions at the expense of other mood-stabilising drugs. In this paper, the range of lithium use in Poland in recent years, in the context of other mood-stabilising drugs, was assessed.

Material and methods. Lithium use in years 2004–2007 was estimated by the data of the Intercontinental Marketing Statistics, expressed as Days of Treatment (DOT) values. Current lithium use in the context of other mood-stabilising drugs (valproates, carbamazepine, lamotrigine, olanzapine, quetiapine, aripiprazole) was assessed by comparing the prescriptions for a given drug for BPD patients in the second half of 2017.

Results. In seven-year period 2004–2010, a minimal increase of lithium use (4%) occurred, while in 2011–2017, this increase amounted to 16%. In the second half of 2017, the use of valproates was nearly three-times higher than lithium while that of quetiapine, olanzapine and lamotrigine about twice as high.

Conclusions. In recent years, a slight increase of lithium use in Poland has occurred. However, compared with other mood-stabilising drugs, lithium has been underutilised. The authors advise more extensive use of lithium for the prophylaxis of recurrences in BPD, both as monotherapy and in combination with other mood-stabilisers.

Address for correspondence:
Klinika Psychiatrii Dorosłych, Klinika Psychiatrii Dzieci i Młodzieży Uniwersytet Medyczny im. K. Marcinkowskiego w Poznaniu
ul. Szpitalna 27/33, 60-572 Poznań, Poland
email: janusz.rybakowski@gmail.com