The Psychopharmacology of Lithium PDF
Preview The Psychopharmacology of Lithium
ISBN 978-1-349-07288-0 9 781349 072880 The Psychopharmacology of Lithium Thisbookisdedicatedto mygoodfriendandcolleague, AthanasioKukopulos,whoseworkhas beenan inspira tion to me, and whose warmth and generosity have always beensofreelyexpressedtowardsme. Included in this dedication are Daniela Reginaldi, LeonardoTondo, and GianpaoloMinnai,allofwhomI holdinthedeepestaffectionandesteem. THE PSYCH OPHARMACOLOGY OF LITHIUM F. Neil Johnson Head ofthe Departmentof Psychology, Universityof lancaster M MACMILLAN PRESS LONDON ©F.NeilJohnson1984 Softcoverreprintofthehardcover1stedition 1984 Allrightsreserved.Nopartofthispublicationmaybereproduced ortransmitted,inanyformorbyanymeans,withoutpermission Firstpublished1984by TheScientificandMedicalDivision THE MACMILLANPRESS LTD LondonandBasingstoke Companiesandrepresentativesthroughouttheworld FilmsettingbyVantagePhotosettingCoLtd EastleighandLondon PrintedinHongKong BritishLibraryCataloguinginPublicationData Johnson,F.Neil ThePsychopharmacologyoflithium. 1.Lithium-Therapeuticuse I.Title 616.89'18 RC483.5.L5 ISBN978-1-349-07288-0 ISBN978-1-349-07286-6(eBook) DOI 10.1007/978-1-349-07286-6 Contents Preface vii 1 Anoverviewoflithiumtherapy 1 2 Thepsychologicalapproachtodrugtreatmentinpsychiatry 6 3 Sensorysystems 12 4 Motorsystems 17 5 Perceptualprocesses 42 6 Intellectualfunctioning 53 7 Responseselectionandinitiation 69 8 Acquisitionandretentionprocesses 72 9 Feelings,moodsandemotionalstates 97 10 Verbalbehaviour 102 11 Sleep 106 12 Socialbehaviour 111 13 Miscellaneousunlearnedbehaviourpatterns 136 14 Circadianandotherperiodicitiesinbehaviour 144 vi CONrn~ 15 Drug-inducedbehaviour 153 16 Problemsinvolvedininterpretinglithium-inducedbehaviour change 171 17 Astimulusprocessingmodeloflithiumaction 188 18 Astimulusprocessingmodelofaffectivedisorders 211 19 Evidencefor astimulusprocessingmodelofaffective disorders 226 20 Psychoanalyticviewsoflithiumaction 245 21 Acircadianrhythmmodelofaffectivedisorders 247 22 Psychologicalpredictionofresponsetolithiumtherapy 256 References 273 Subjectindex 321 Preface It isalmost 35 years sinceCade rediscovered the therapeuticpropertiesof lithium in the treatment of manic excitement, and lithium salts are now firmly established in modern psychiatric treatment. It is, therefore, some thingofacuriositythatrelativelylittlehasbeenwrittenaboutthepsycholog ical mechanisms by which the lithium ion brings about its effects. Beinga simpleionandsocloselyrelatedto sodiumandpotassium,lithiumnaturally attracted the attention of biochemists and physiologists alike, but psychologists have-for one reason or another-not been as drawn to lithiumastheyhavebeento chlorpromazine,for example. Thisbookrepresentsinpartan attempttocorrectthesituation,bypulling togetherwhatstrandsofevidenceexistconcerningthepsychopharmacology of lithium. Somewhere amongst the information which already exists-disparate and formless as it often is-there lie the clues to a psychological modeloflithium action, and I have done mybestto identify them.WhetherIhavesucceeded,Idonotknow. I have presented at some length my own proposed model of lithium action,basedontheideaofstimulusprocessing,andhavethendevelopeda modelofmanicdepressionusingthesameconcepts,notbecauseIamfirmly convinced that this is the only, or indeed the best, approach to lithium psychopharmacology,butsimplyto illustratethegeneralmannerinwhichI wouldliketo seethepsychologicalapproachto lithiumdevelopingoverthe nextfew years. I am convinced thatifwe can establish a viable psychologicalmodel (or models)of actionofagentswhichareeffectiveagainstmaniaanddepression weshallhavethekey to thepsychologicalprocessesunderlyingtheaffective disorders;Iam furtherconvincedthatinthisendeavourthestudyoflithium offers us the best chance of a breakthrough in the initial model-building process. I hope that The Psychopharmacology ofLithium will serve a numberof different, butcomplementary, purposes. It isareferencetext,andassuchI viii PREFACE havetriedtomakeitascompleteaspossible.Ihavebeengreatlyaidedinthis by the fact that the British Lithium Index, housed at the University of Lancaster, contains copies of practically all that has been published on lithiumfromabiologicalpointofview: IamgreatlyindebtedtomyEditorial Assistant,MrsJulieWest,whomaintainstheIndexwithgreatefficiencyand without whose help and knowledge it would not have been possible to complete this book. Delandale LaboratoriesLtd, of Canterbury,Kent,the manufacturersof Priadel, have for a numberofyearsprovidedthefunding necessaryto maintaintheBritishLithiumIndexandtheeditorialassistance neededto runit, anditismypleasureto acknowledgeMrJ. M. Olivant,the Managing Director of Delandale, for his generosity and encouragement. The pharmaceutical industry frequently comes under attack from many directions: societyseemstohavealove-haterelationshipwiththemanufac turers of its medicines, but in so manyareasof basicmedicalresearchthe drug companies make possible workwhichcouldnototherwisebe carried out. Delandale Laboratories, in particular, takeveryseriouslytheirrolein encouragingresearch. In addition to the book's purely reference function, I hope that the theoretical discussions which it contains will prompt others to undertake similar exercises or at least to test some of the propositions which I have advanced. If I can, in somesmallway, give a little impetusto psychophar macologicalresearchonlithiumIshallbewellsatisfied. Forthosewhoarenotwell acquaintedwiththepsychologicalapproachto the study of drug action, this bookmayserve as an introduction. Tothose who wish to relate their physiological or biochemical studies to the be havioural andcognitive aspectsof drugeffects,itmayhelpto pointto ways inwhichsuchasynthesismaybe achieved. Ihaveaimedthebookatallthosewhostudy,employortakeaninterestin lithiumtherapyinparticularandinpsychoactiveagentsingeneral. The greater part of the manuscript for this book was prepared in the course of a period of sabbatical leave spent at the Centre de Recherche Delalande, at Rueil-Malmaison near Paris, and I wish to express my warmestthanksto allthosewhomademystaytheresopleasantandfruitful. The manuscript, in the most appalling handwriting, was turned into a legible typescript by Sylvia Boyle. How she did it-and so quickly and accurately, too-I shall never understand; but she did, and I am very grateful. Mythanksaredueto allthosefriendsandcolleagueswho offeredadvice, clarified points, or generally encouraged me. As always, the greatest stimulustoperseverewithwhat,attimes,seemedanendlessdrudgery,came from my wife, Susan, and I thankher andmychildren,ReubenandJenny, for the understandingwhichtheyshowed, particularlyat thosetimeswhen papers littered our home and my conversation consisted of irritable monosyllables. The Psychopharmacology ofLithiumis the latest in a seriesof bookson PREFACE ix lithiumwithwhichIhavebeeninvolved.It maynotbethebest,andIdonot doubtthatit will notbethelast,butithascertainlybeenthemosttaxingto write and, in the end, maybethe onewithwhichI have most reasonto be pleased-that depends on what it achieves, and I have no way of even guessingwhatthatmaybe. Lancaster,1983 F.N.J.
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