Lithium: A Doctor, a Drug, and a Breakthrough

December 1, 2020
Lithium: A Doctor, a Drug, and a Breakthrough

The remarkable untold story of a miracle drug, theforgotten pioneer who discovered it, and the fight to bring lithiumto the masses.The DNA double helix, penicillin, the X-ray, insulin—these areroutinely cited as some of the most important medical discoveriesof the twentieth century. And yet, the 1949 discovery of lithium asa cure for bipolar disorder is perhaps one of the mostimportant—yet largely unsung—breakthroughs of the modern era. InLithium, Walter Brown, a practicing psychiatrist and professor atBrown, reveals two unlikely success stories: that of John Cade, thephysician whose discovery would come to save an untold number oflives and launch a pharmacological revolution, and that of amiraculous metal rescued from decades of stigmatization.From insulin comas and lobotomy to incarceration to exile, Brownchronicles the troubling history of the diagnosis and (oftenineffective) treatment of bipolar disorder through the centuries,before the publication of a groundbreaking research paper in 1949.Cade's "Lithium Salts in the Treatment of Psychotic Excitement"described, for the first time, lithium's astonishing efficacy atboth treating and preventing the recurrence of manic-depressiveepisodes, and would eventually transform the lives of patients,pharmaceutical researchers, and practicing physicians worldwide.And yet, as Brown shows, it would be decades before lithium wouldovercome widespread stigmatization as a dangerous substance, andthe resistance from the pharmaceutical industry, which had littleincentive to promote a naturally occurring drug that could not bepatented.With a vivid portrait of the story's unlikely hero, John Cade,Brown also describes a devoted naturalist who, unlike many modernmedical researchers, did not benefit from prestigious researchtraining or big funding sources (Cade's "laboratory" was the unusedpantry of an isolated mental hospital). As Brown shows, however,these humble conditions were the secret to his historic success:Cade was free to follow his own restless curiosity, rather thananswer to an external funding source. As Lithium makes tragicallyclear, medical research—at least in America—has transformed in sucha way that serendipitous discoveries like Cade's are unlikely tooccur ever again.Recently described by the New York Times as the "Cinderella" ofpsychiatric drugs, lithium has saved countless of lives andbillions of dollars in healthcare costs. In this revelatorybiography of a drug and the man who fought for its discovery, Browncrafts a captivating picture of modern medical history—revealingjust how close we came to passing over this extraordinary cure.