Lithium and the kidney

Lithium was the first drug to receive U.S. Food and Drug Administration (FDA) approval for the treatment of bipolar disorder, back in 1970. Although it's common knowledge that the Australian psychiatrist John Cade initially described lithium's anti‐manic efficacy in 1949, it's less well known that the FDA banned lithium that same year. This occurred following the deaths from lithium intoxication of several patients with hypertension and congestive heart failure who had been given lithium chloride as a salt substitute.1 To be sure, the pharmaceutical industry did little to advance lithium — since it couldn't be patented, there was no profit to be made — but it's hard for us now to imagine that it could take more than 20 years to approve a new drug for a major illness with no other approved treatment.