Lithium conduct disorders

Some (Campbell et ah, 1995 Malone, et ah, 2000) but not all (Rifkin et ah, 1997), controlled studies of lithium among children with conduct disorder (CD) appear to support lithium s efficacy in the treatment of aggression in this population. Both aggression and irritability are symptoms that cut across diverse disorders and are important confounders in studies of impulse dyscontrol. Double-blind controlled studies are needed to further validate the choice of lithium for patients with BD presenting with excessive irritability and anger outbursts (Fava, 1997). 

Campbell, M., Adams, P.B., Small, A.M., Kafantaris, V., Silva, R.R., Shell, J., Perry, R., and Overall, J.E. (1995) Lithium in hospitalized aggressive children with conduct disorder a double-blind and placebo-controlled study. / Am Acad Child Adolesc Psychiatry 34 445-453. [published erratum appears in / Am Acad Child Adolesc Psychiatry 1995 34(5) 694]. ... 

Rifkin, A., Karajgi, B., Dicker, R., Perl, E., Boppana, V., Hasan, N., and Pollack, S. (1997) Lithium treatment of conduct disorders in adolescents. Am Psychiatry 154 554-555. 

Lithium, carbamazepine, valproate, and antipsychotics have all been tried, with variable success, as therapy for conduct disorder in typically developing... 

Divalproex (Depakote) was found to reduce temper outbursts and emotional lability in 10 adolescents with conduct disorder (Donovan et al., 1997). Studies of carbamazepine have yielded conflicting results. Cueva et al. (1996) did not find carbamazepine to be more effective than placebo in treating children hospitalized for conduct disorder in a double-blind, placebo-controlled study. As in the case of lithium, side effects (rashes, leukopenia, nausea, drowsiness) can be an issue with carbamazepine, offsetting its use. 

Aman s (1993) review of lithium treatment for self-injury revealed that the drug has only inconsistently been shown to suppress such behaviors. The available case reports have been far more positive than the placebo controlled research. Kastner et al. s (1993) positive but uncontrolled study of lithium in adolescents and adults practicing aggression and self-injury was described earlier (see Conduct Disorder, above). Finally, single-subject studies of carbamazepine have yielded mixed results (Aman, 1993). 

Klein, R.G. (1991) Preliminary results lithium effects in conduct disorder. In CME Syllabus and Proceeding Summary, Symposium 2 The 144th Annual Meeting of the American Psychiatric As-sociation, New Orleans, LA, May 11-16, 1991. Washington, DC American Psychiatric Association, pp. 119-120. 

Malone, R.P., Delaney, M.A., Luebbert, J.F., Cater,/., and Campbell, M. (2000) A double-blind placebo-controlled study of lithium in hospitalized aggressive children and adolescent with conduct disorder. Arch Gen Psychiatry 57 649-654. 

Campbell M, Adams PB, Small AM. Lithium in hospitalized aggressive children with conduct disorder a double blind placebo controlled study. J Am Acad Child Adolesc Psychiatry 1995 34 445-453. 

In addition, it exerts beneficial effects in many disorders as an adjuvant to other treatment modalities. Such effects are apparent only if it is administered to an already pharmacologically treated patient. For example, in unresponsive major depressive disorder, the co-administration of lithium to an ongoing antidepressant treatment increases the response rate by up to 50%. In most cases, the response to lithium augmentation is either considerable or not at all ( all-or-none phenomenon). Some (currently not convincing) results have also been reported in unipolar depression, bulimia nervosa, and attention deficit hyperactivity disorder (ADHD). Lithium also exerts antiaggressive effects in conduct disorder, independent of any mood disorder, and can reduce behavioral dyscontrol and self-mutilation in mentally retarded patients. One of the most striking effects of lithium is its antisuicidal effect in patients who suffer from bipolar and unipolar depressive disorder irrespective of comorbid axis I disorder. ... 

Masi G, Milone A, Manfredi A, Pari C, Paziente A, Millepiedi S. Effectiveness of lithium in children and adolescents with conduct disorder a retrospective naturalistic study. CNS Drugs 2009 23(1) 59-69. 

Li2S04 these phases undergo a phase transition on heating to yield a highly disordered material that shows facile Li" " migration. The conductivity in the high temperature phases are of the same order as that seen in P-Li2S04 but in some cases it has been possible to reduce the transition temperature and so access fast lithium conduction at a lower temperature than in the lithium sulfate parent. 

The NASICON structure is capable of accommodating considerable compositional variation and a large number of related compounds have been studied in order to try an improve the lithium ion conducting properties. There have been two distinct approaches to this. One approach has been to try and reduce the temperature of the structural transition and reduce the barrier to ion mobility and so access a compound that shows fast lithium conductivity under ambient conditions. An alternative strategy is to adjust the number of mobile cations and vacant sites in order to increase the conductivity of the cations in the higher temperature, disordered phase. Both approaches have had considerable success in both illuminating the mechanism for ion motion in the structure and in changing the physical properties towards those of a useful fast ion conductor. 

According to this model, the SEI is made of ordered or disordered crystals that are thermodynamically stable with respect to lithium. The grain boundaries (parallel to the current lines) of these crystals make a significant contribution to the conduction of ions in the SEI [1, 2], It was suggested that the equivalent circuit for the SEI consists of three parallel RC circuits in series combination (Fig. 12). Later, Thevenin and Muller [29] suggested several modifications to the SEI model ... 

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