THE article "Forty Years of Lithium Treatment"1 represents a remarkable journey of 40 years by Schou, one of the pioneers in the treatment of manic-depressive illness and one of the most fervent advocates for lithium prophylaxis. Schou's article is based on a lecture given at the introductory plenary session of the First International Conference on Bipolar Disorder held in Pittsburgh, Pa, June 23-24, 1994.
The major purpose of this conference was to identify both current advances in the treatment of bipolar disorder and unresolved problems in both the short- and long-term treatment of this severe psychiatric disorder. Many of the speakers demonstrated their concern that as many as 40% of patients with bipolar disorder are not effectively treated with lithium. Since the development of alternative forms of therapy has become of increasing importance, it seems appropriate to review the current assets and liabilities of lithium treatment.