Lithium for ocd


Management of obsessive-compulsive disorder comorbid with bipolar disorder

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The Incredible, The Amazing, Lithium!

It’s an amazing metal. Not only does it treat acute mania, prevent recurrences, and treat refractory depression, but when consumed as LiCl, it tastes pretty good on vegetables. Or at least it did before the 1950s, when it was dropped from the list of acceptable salt-substitutes for hypertensives because of a nasty tendency to cause toxicity.

The history of lithium is colorful, and is covered elsewhere in this month’s issue. In this article, TCR covers lithium from a clinical perspective, in the hopes of reminding you that it’s easy to prescribe and to monitor, it’s effective, and it’s very cheap.

Lithium’s benefits

In treating acute manic episodes, lithium’s response rate is in the range of 70-80%. That’s the good news. The bad news is that it takes up to two weeks to kick in, and thus is about a week slower than its main competitors, Depakote and the atypical antipsychotics. This is not a huge problem, however, because we will often use adjunctive neuroleptics or benzodiazepines for acute mania anyway.

Not only does lithium treat mania, but it is the only medication in the world that has been shown to be more effective than placebo in preventing recurrences of both mania and depression in bipolar disorder (1). Other medications may be effective for preventing specific problems in bipolar disorder. Thus, Lamictal (lamotrigine) prevents bipolar depression, and a recently reported but not yet peer-reviewed abstract reports that Zyprexa (olanzapine) was better than lithium at preventing relapse to mania in one trial (2). But lithium has been shown effective in bipolar disorder prophylaxis in study after study over the last 30 years.

Lithium is a good antidepressant, and is currently one of two drugs recommended in APA Guidelines for the treatment of bipolar depression (3). Lithium is the only psychiatric medication (other than clozapine) proven to prevent suicide. Meta-analytic studies have reported a 93% reduction in suicide acts in patients on lithium. Interestingly, lithium’s antisuicide effect was most robust in recurrent major depression, although it was still a boon in both bipolar I and bipolar II disorders. Does this suicide data imply that we should be putting all our severely depressed patients on lithium, whether they have bipolar disorder or not? It’s an arguable point!

There are a variety of allegations floating around related to certain supposed advantages of Depakote over lithium, especially in any manic presentation other than classic euphoric mania. Read the Depakote article in this issue for TCR‘s version of clarity on this topic.

How to Use Lithium

Now that you’re chomping at the bit to start prescribing lithium, how should you do it? Start by getting baseline TSH, T4, and BUN/Cr levels drawn before the first dose, and then start with regular old Lithium Carbonate, 300 or 600 mg QHS. LiCO3 may cause a bit more initial GI distress than Eskalith CR or Lithobid but it’s about half the price. Lithium’s half life is 24 hours, so don’t even think of dosing more than once a day, unless it becomes clear over time that your patient has fewer side effects with split dosing. Dosing it at night also has the beneficial effect of causing less polyuria.

Try to get the lithium level up to 0.8 meq/L or so. Comparative studies have shown that higher serum levels are more effective at preventing relapse, but on the down side, they lead to lower tolerability and more treatment drop-out. So shoot for 0.8, but if you have to drop down to 0.6 or 0.7 to maintain a happy camper, by all means do so. You’ll probably end up at a dose between 900 mg – 1500 mg QHS for most patients.

Check lithium levels, TSH/T4, and BUN/Cr after one week, at one to two months, then every 6 to 12 months thereafter. The most common side effects are GI discomfort (remedies: split dosing, take with meals, switch to long-acting formulation, or switch to Li Citrate syrup), tremor (use Inderal LA 60 mg QAM or regular Inderal 20 mg BIDTID prn), polyuria/excessive thirst (dose it all at night, use low dose hydrochlorthiazide but watch lithium levels, which will often increase on this regimen), memory problems (no proven remedy, some try stimulants or acetylcholinesterase inhibitors), weight gain (diet and exercise and prayer).

Two side effect issues are confusing and controversial. First, can lithium actually damage the kidneys, beyond causing reversible polyuria? The answer is: probably, but it’s quite rare. A ten-year prospective followup study of lithium’s effects on the kidney found that declining kidney function was more related to age of the patient than duration of lithium use. One risk factor appears to be a history of frank lithium toxicity. Bottom-line is that kidney damage is unlikely, but caution dictates yearly BUN/Cr levels.

The second issue is lithium’s effects on the heart. A Medline search reveals many case reports of lithium-induced sinus node dysfunction. Recall that the sinus node is our main cardiac pacemaker, and keeps our hearts beating in the 60-100 range. The usual symptoms of sinus node dysfunction are the results of bradycardia–fatigue, dizziness, and fainting. Studies that have bothered to measure sinus node functioning in large groups of patients on lithium have been pretty reassuring: severe, symptomatic sinus node dysfunction is quite rare (5). Based on this, a common sense approach would be to: 1) Get a pre-lithium EKG in patients with documented cardiac disease, especially in patients over 50, who have a higher rate of bradycardia due to age alone; and 2) Order an EKG in any lithium treated patient who has new onset dizziness or fainting.

TCR VERDICT: Dont Neglect the Magic of Lithium!

23 roles of lithium in the human body. Scientific data.

Lithium is an alkali metal found naturally in trace amounts in minerals, water, soil, and fruits, vegetables, and other plants grown in lithium-enriched soils (https://www.ncbi.nlm.nih.gov/pubmed /11601880).
Lithium is essential for the proper functioning of a number of enzymes, hormones, vitamins, growth factors and the immune and nervous systems (https://www.igsli.org/general-information-on-lithium/biochemical-effects-of-lithium.html).
In addition to lithium's role in treating psychiatric patients, this mineral has many health benefits, and the list continues to grow.

1. Lithium has a neuroprotective effect (protection of brain cells)

Long-term lithium treatment reduces glutamate-induced toxicity mediated by N-methyl-D-aspartate (NMDA) receptors. This effect was at least partially explained by the ability of lithium to suppress calcium influx, which affects the activity of the NMDA receptor. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3172812/#R39)
Thus, lithium has the potential to be beneficial for conditions such as mood disorders, Alzheimer's, diabetes, cancer, and inflammatory and autoimmune diseases (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3172812/# R39).

2. Lithium inhibits apoptosis

Lithium increases levels of heat shock proteins (HSPs), which promote proper 3D folding of proteins, refolding of damaged proteins, and utilization of atypical proteins (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3172812/#R39).
Among heat shock proteins, HSP70 has a wide range of neuroprotective effects against apoptosis. These effects are caused by GSK-3 inhibition (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3172812/#R39). Lithium is also known to inhibit GSK-3 (https://www.ncbi.nlm.nih.gov/pubmed/8994831).
Long-term lithium treatment has been noted to induce the production of Bcl-2, a protein in the frontal lobe of the brain that protects cells from apoptosis (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3172812/#R39).

3. Lithium increases levels of neurotrophic factors BDNF, NGF and GDNF

Prolonged exposure of neurons to lithium in culture induces BDNF activity. (reference 2)
BDNF is one of the main neurotrophic agents indispensable for cognitive development, synaptic plasticity and neuronal survival, which also has antidepressant and calming effects. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3172812/#R39)
This probably occurs as a result of GSK-3 inhibition. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3172812/#R39)
Lithium also increases nerve growth factor (NGF) and glial neurotrophic factor (GDNF) levels in the hippocampus, frontal cortex, occipital region, and striatum (https://www. ncbi.nlm.nih.gov/pubmed/12974988). NGF and GDNF help increase neuronal survival and plasticity (the ability to regenerate and form new connections) among dopaminergic, cholinergic, and serotonergic neurons in the central nervous system.

4. Lithium promotes the regeneration of cerebral and cardiac vessels (VEGF)

Lithium leads to an increase in the production of vascular endothelial growth factor, VEGF, which promotes cell growth and regeneration of blood vessels after a stroke (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3172812/#R39).
By increasing VEGF levels, lithium may promote faster recovery after a stroke or heart attack (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3172812/#R39).
The likely mechanism is lithium inhibition of GSK-3 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3172812/#R39).

5. Lithium induces autophagy

Autophagy or "cell self-destruction" is when cells break down and recycle cellular components to reuse raw materials (https://www. ncbi.nlm.nih.gov/pmc/articles/PMC3172812/#R39). Autophagy is thought to slow down aging, prevent cancer, and is important for neuronal function and survival (http://genesdev.cshlp.org/content/21/22/2861.full, https://www.ncbi.nlm.nih .gov/pmc/articles/PMC2020444/).
Lithium can induce autophagy by depleting inositol stores independently of mTOR inhibition (which by itself usually induces autophagy) (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3172812/#R39).
Since lithium induces autophagy, the drug may be especially useful for patients with neurodegenerative diseases - Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis and Huntington's disease, since such disorders are characterized in part by the accumulation of misfolded proteins (https://www.ncbi.nlm .nih.gov/pmc/articles/PMC3172812/#R39).

6. Lithium increases neurogenesis and improves cognitive function

Lithium has been found to stimulate progenitor and stem cells in a culture of brain hippocampal neurons (neurons from the memory center). In addition, lithium prevents loss of proliferation caused by glutamate or cortisol (glucocorticoids). Also, long-term lithium treatment promotes the conversion of these precursor cells into neurons (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3172812/#R39).
In addition, long-term lithium treatment not only improves neurogenesis in the hippocampus (memory center) in healthy mice, but also restores neurogenesis in the brain of an animal model of Down syndrome (https://www.ncbi.nlm.nih.gov/pmc/articles /PMC3172812/#R39).
The drug also enhances neurogenesis (the formation of new neurons) in the subventricular zone, the only area besides the hippocampus (memory center) where such an effect was observed, which caused a persistent increase in gray matter volume in patients (https://www.ncbi.nlm.nih. gov/pmc/articles/PMC3172812/#R39).
Lithium increases N-acetyl aspartate (NAA) levels (http://www.biologicalpsychiatryjournal.com/article/S0006-3223(00)00252-3/abstract), which can be seen as an indicator of creativity and correlates with IQ scores (https http://www. ncbi.nlm.nih.gov/pubmed/21983183). One possible consequence of this may be more efficient communication between the two hemispheres of the brain, resulting in improved brain activity. (https://www.ncbi.nlm.nih.gov/pubmed/21983183)
Long-term lithium treatment increases long-term potentiation (LTP) in hippocampal neurons, which makes nerve cells more efficient and thus aids in learning and memory (http://europepmc.org/abstract/MED/17996377).

7. Lithium can calm and stabilize mood

In animals, lithium staunchly reduces search activity and aggression. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2150568/)
In humans, lithium is also known to have a calming and mood-stabilizing effect, and is also used to treat depression, bipolar disorder, and schizophrenia (https://en.wikipedia.org/wiki/Lithium_(medication).
Lithium carbonate is the standard of care for bipolar affective disorder (BAD), reducing the frequency of manic episodes (https://www. ncbi.nlm.nih.gov/pmc/articles/PMC2560740/pdf/10885180.pdf, https://www. ncbi.nlm.nih.gov/pmc/articles/PMC3181868/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3876031/).
Lithium has also been shown to be effective in reducing aggressive behavior in people with attention deficit hyperactivity disorder (ADHD) (https://www.ncbi.nlm.nih.gov/pubmed/12154153).
Increased levels of naturally occurring lithium in drinking water may reduce suicide rates (https://en.wikipedia.org/wiki/Lithium_(medication)). This may be partly due to the fact that lithium increases the synthesis and release of serotonin (it also reduces the level of norepinephrine) (https://en.wikipedia.org/wiki/Lithium_(medication)).
Lithium increases CCK levels in the brain and this is part of the mechanism by which lithium prevents mania in bipolar disorder.

8. Lithium fights depression

Lithium administration is one of the most studied approaches in the treatment of depression refractory to standard therapy (https://www. ncbi.nlm.nih.gov/pubmed/22796912).
Lithium increases postsynaptic sensitivity to serotonin via the 5-HT1A receptor, which partly explains its antidepressant activity. (http://onlinelibrary.wiley.com/doi/10.1002/syn.8

302/abstract?systemMessage=Wiley+Online+Library....)
Lithium also increases BDNF levels, which helps with depression.
Lithium partially alleviates depression in animals by increasing the number of neural stem cells.

9. Lithium has potential use in the treatment of Huntington's disease

Lithium prevents nerve cell death in animal models of Huntington's disease (https://www.ncbi.nlm.nih.gov/pubmed/11591460, https://www.ncbi.nlm.nih.gov/pubmed/14702090).
Lithium reduces excess NMDA receptor function, and thus may potentially counteract the increased NMDA receptor activation that occurs in the brains of patients with Huntington's disease (https://www.ncbi.nlm.nih.gov/pubmed/21492946).
Research into patients with Huntington's disease is ongoing.

10. Lithium reduces insulin resistance

Lithium improves insulin-stimulated glucose transport and glycogen synthesis in insulin-resistant rat muscle rat muscle (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC26339thirty/). These effects depend on p38 MAPK (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2633930/).
Lithium reduces insulin release (https://www.ncbi.nlm.nih.gov/pubmed/369819).
The use of lithium significantly increased glucose transport into muscle cells by 2.5 times in response to insulin administration and also increased insulin sensitivity (https://www.ncbi.nlm.nih.gov/pubmed/8013755).

11. Lithium has a positive effect on autoimmune diseases and reduces inflammation

Lithium has shown strong immune system activation effects (https://www.ncbi.nlm.nih.gov/pubmed/15236914/, https://www.ncbi.nlm.nih.gov/pubmed/12208183).
Lithium, by inhibiting GSK-3, has been noted to have a beneficial effect in animal models of autoimmune disease. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3532311/)
Lithium inhibits the activity of Th2 cells and interferon-gamma (but not Th27 cells). (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3532311/)
Lithium has anti-inflammatory effects by decreasing the production of IL-1β and TNF-α, and increasing the production of IL-2, TGF, IL-1RA and IL-10 (http://www.if-pan.krakow.pl/pjp/pdf/ 2003/3_353.pdf, https://www.ncbi.nlm.nih.gov/pubmed/10367558).
However, studies have also shown that, under certain experimental conditions, lithium also has pro-inflammatory effects by increasing the production of IL-4, IL-6 and TNF-α (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4063502 /).
Lithium increases IgG and IgM antibody levels (https://www.sciencedirect.com/science/article/pii/009825).
Lithium reduces the production and activity of prostaglandins, thus preventing their negative effect on the immune system (https://www.sciencedirect.com/science/article/pii/0006295274

9).
Lithium reduces the frequency and duration of recurrent infections of labial and genital herpes, and also reduces the frequency of colds (https://www.ncbi.nlm.nih.gov/pubmed/2155671, https://jhu.pure.elsevier.com/ en/publications/suppression-of-recurrent-genital-herpes-infections-wit...).

12. Lithium has a positive effect on bone tissue

A comparative study was conducted to assess the bone density of the hip and lumbar spine in 75 volunteers who received lithium and 75 healthy volunteers who did not receive lithium; groups were normalized for age, sex, and body mass index. The study found lower rates of bone remodeling in volunteers who received lithium. Mean bone mineral density in lithium-treated volunteers was 4.5% higher at the spine, 5.3% higher at the femoral neck, and 7.5% higher at the trochanter of the femur (https://www.ncbi .nlm.nih.gov/pubmed/18992857).
Lithium use is associated with a reduced risk of bone fractures and increased osteogenesis , https://www. ncbi.nlm.nih.gov/pmc/articles/PMC1297659/).

13. Lithium can be helpful in restoring our circadian rhythm

As you know, lithium is the standard of care for the treatment of patients suffering from bipolar disorder, which is characterized by the presence of episodes of mania and depression.
One mechanism by which lithium may help with bipolar disorder is by lengthening the circadian rhythm. People with bipolar disorder tend to have a shorter circadian rhythm compared to 24 hours.
Lithium promotes a faster recovery of our circadian rhythm in response to light and darkness (http://geum.ru/next/art-91286.php).

14. Lithium improves mitochondrial function

Lithium increased the lifespan of roundworms (nematodes) and improved overall health outcomes, including mitochondrial energy production (https://www.ncbi.nlm.nih.gov/pubmed/24398558).
Lithium may improve mitochondrial function by increasing the rate of replacement of broken mitochondria (https://www. ncbi.nlm.nih.gov/pubmed/24398558).
Lithium also inhibits mir-34a, which in turn inhibits NAMPT, an enzyme involved in the formation of NAD+ (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3172812/#R39, https://en .wikipedia.org/wiki/Nicotinamide_phosphoribosyltransferase). Therefore, lithium likely increases free NAD+ levels.

15. Low doses of lithium increase life expectancy

The researchers found a positive correlation between life expectancy and lithium levels in drinking water. There has been a decrease in the risk of death from all diseases in areas of Japan with higher lithium levels.
Similar was noted in the situation with roundworms (nematodes). Long-term low-dose lithium exposure can delay aging and clearly reduce mortality in evolutionarily distinct species (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3151375/). The improvement in health status was accompanied by improved mitochondrial function. (https://www. ncbi.nlm.nih.gov/pubmed/24398558)

16. Lithium may improve symptoms of Tourette's syndrome

Tourette's syndrome is a neurological disorder characterized by involuntary muscle movements and uncontrolled vocal sounds (https://www.nhs.uk/conditions/tourettes-syndrome/).
In a small study of 3 patients, lithium resulted in a better outcome than haloperidol, a common drug prescribed for Tourette's syndrome. In patients who took lithium, there was a significant decrease in the number of tics and involuntary speech sounds. Patients had no side effects and were symptom-free for several months (https://www.ncbi.nlm.nih.gov/pubmed/27089four).

17. Lithium may be useful in cases of tardive dyskinesia

Tardive dyskinesia is a neurological disorder characterized by sudden, involuntary, jerky movements of the face and/or body that occur with long-term use of psychotropic drugs (https://www. ninds.nih.gov/Disorders/All-Disorders/Tardive-Dyskinesia- Information-Page).
Studies have shown that lithium significantly reduced the severity of tardive dyskinesia (https://www.sciencedirect.com/science/article/pii/S0924977X07001496, https://www.ncbi.nlm.nih.gov/pubmed/788002, https://www.ncbi.nlm.nih.gov/pubmed/804260).
Lithium reduced arousal and aggression, and reduced involuntary movements (https://www.ncbi.nlm.nih.gov/pubmed/788002, https://www.ncbi.nlm.nih.gov/pubmed/804260).
However, two large studies found no consistent effects of lithium on tardive dyskinesia (https://www.ncbi.nlm.nih.gov/pubmed/7

, https://www.karger.com/Article/Abstract/117629).

18. Lithium helps to cope with obsessive-compulsive behavior

Obsessive-compulsive disorder (OCD), or obsessive-compulsive disorder, is a mental disorder characterized by obsessive thoughts and behavior (https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index. shtml).
The addition of lithium to the diet results in a reduction in OCD symptoms resistant to standard therapy (https://www.ncbi.nlm.nih.gov/pubmed/6435460).
Compulsive and pathological gamblers have also shown a good response to dietary lithium supplementation, which may regulate dopamine imbalance in the brain (https://www.ncbi.nlm.nih.gov/pubmed/20588072).

19. Lithium can relieve headaches

Lithium can reduce the severity of both chronic and episodic cluster headache (http://scielo.isciii.es/scielo.php?pid=S0213-616320000006&script=sci_arttext).
Lithium carbonate taken before bed helped eliminate "hypnic headache" (headache that older people suffer from waking up at the same time at night) (https://www.ncbi.nlm.nih.gov/pmc/ articles/PMC1891726/, http://pn.bmj.com/content/practneurol/5/3/144.full.pdf).

20. Lithium may be effective in treating anorexia nervosa

Patients suffering from anorexia nervosa for many years have been successfully treated with lithium carbonate (https://www. ncbi.nlm.nih.gov/pubmed/842388, https://www.ncbi.nlm.nih.gov/pubmed /6801096).
One patient gained 12 kg and the other 9 kg within 6 weeks, and the weight gain on lithium therapy was maintained for a year (https://www.ncbi.nlm.nih.gov/pubmed/842388).
However, further studies of lithium are required to evaluate its utility in the treatment of anorexia nervosa.

21. Lithium may be effective in treating alcoholism

Lithium orotate is used to treat alcoholism.
The drug has been shown to be safe, with minimal side effects such as muscle weakness, loss of appetite, or mild lethargy (https://www.ncbi.nlm.nih.gov/pubmed/3718672).
Lithium carbonate promotes alcohol abstinence, reduces subjective withdrawal symptoms, and delays time to first alcohol consumption (https://jamanetwork.com/journals/jamapsychiatry/article-abstract/494005, https://www.ncbi.nlm.nih.gov /pubmed/181193).
Patients treated with lithium were less likely to be rehospitalized for alcohol rehabilitation during 18 months of follow-up (https://www. ncbi.nlm.nih.gov/pubmed/2494686).

22. Lithium may reduce seizure frequency

Data on the effect of lithium on seizure frequency is still controversial (https://www.ncbi.nlm.nih.gov/pubmed/3379144).
Some patients with epilepsy show a statistically significant reduction in seizure frequency as well as behavioral improvement with lithium treatment (https://jamanetwork.com/journals/jamapsychiatry/article-abstract/490891).
Lithium can be used to control treatment-resistant temporal lobe epilepsy.
However, some patients with epilepsy have experienced an increase in the number of seizures during lithium treatment (https://www.healio.com/psychiatry/journals/psycann/2013-6-43-6/%7B0346b54f-2ca1-4215-8d9e-10708601ad..., http://www.academia.edu/6195616/Non-convulsive_status_epilepticus_during_lithium_treatment_at_therap..., https://neuro.psychiatryonline.org/doi/full/10.1176/jnp.11.3.414).

23. Lithium may relieve symptoms of Meniere's disease

Meniere's disease is an ear disease that causes severe dizziness, tinnitus, hearing loss, and a feeling of fullness in the ear (https://www.mayoclinic.org/diseases-conditions/menieres-disease/symptoms-causes/syc-203749ten).
In 70% of patients with Ménière's disease, a decrease in the frequency and severity of seizures was observed during lithium treatment (http://www.tandfonline.com/doi/abs/10.3109/00016487409126326?journalCode=ioto20&).
However, in a study involving patients who received lithium and placebo for 6 months, there was no difference between the two groups (https://www.ncbi.nlm.nih.gov/pubmed/790893).

Additional information

• Lithium reduces brain levels of inositol (https://www.nature.com/articles/newbio233267a0).
• Lithium increases vasopressin, which stimulates ACTH and cortisol (http://journals.plos.org/plosone/article?id=10. 1371/journal.pone.0027613).

Genetic factors that influence lithium sensitivity

Serotonin transporter 5-HTTLPR (SLC6A4)
Patients with 2 copies of the short form of this gene respond less well to lithium treatment than patients with the long form of the gene (https://www.nature.com/articles/6500006).
Corresponding allele: The presence of rs25531 may indicate the long form of the gene.

GSK3beta -50T/C
These mutations are responsible for the variability in responses to lithium in patients with bipolar disorder, although the results are not uniform (https://www.ncbi.nlm.nih.gov/pubmed/14729229, https://www.ncbi.nlm. nih.gov/pubmed/15694273, https://www.ncbi.nlm.nih.gov/pubmed/16861141)
The C allele is associated with a more improved response to lithium supplemented antidepressants (https://www.ncbi.nlm.nih.gov/pubmed/17628506).


Journal of the RAS

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Sovremennaya Evropa

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The main block of journal materials consists of original articles in which qualified specialists in the history and philosophy of science and technology publish the results of their research. The journal is published under the direction of the Presidium of the Russian Academy of Sciences.


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