Lithium For Treating Gout

I’m impelled to add information to the “Limits of Lithium” cover story (C&EN, March 25, page 15). In 1859, Sir Alfred Baring Garrod was aware of the high solubility of lithium urate. He proposed that lithium salts be used to solubilize uric acid deposits in the joints of gout patients and thus relieve joint pain. At the time, several different forms of gout disease had been described, including “regular gout” and “irregular gout,” also known as “manic gout.”

Needless to say, gout symptoms were not alleviated by lithium salts; however, manic gout patients calmed down. In this way, lithium salts eventually came to be used to treat bipolar illness. In the 1940s, the Food & Drug Administration banned the medical use of lithium salts owing to serious side effects. In some cases, the toxic effects kicked in at just three times the therapeutic dose. The ban, coupled with strict advice to monitor patients on lithium therapy, was lifted in 1970. Because lithium ion cannot be patented, it’s not surprising that its mechanism of action on brain function is so little understood.

I recommend “The Early History of Lithium Therapy” in “Lithium: Current Applications in Science, Medicine, and Technology” edited by Ricardo O. Bach, Wiley InterScience, John Wiley & Sons, 1985.

Gideon Fraenkel
Columbus, Ohio