This paper discusses essential issues related to long-term lithium therapy and presents a case of successful 50-year lithium treatment. Lithium is currently regarded as the drug of choice for preventing manic and depressive recurrences in bipolar disorder. In 1/3 of patients with bipolar disorder, long-term monotherapy with lithium can completely prevent recurrences of abnormal mood. Numerous clinical and psychosocial factors associated with a good response to lithium have been described. Lithium is more efficacious than other mood stabilizers, and its long-term treatment significantly exceeds them. Lithium also exerts antisuicidal, immunomodulatory, and neuroprotective effects. The main problems associated with long-term lithium treatment include kidney, thyroid, and probably cognitive issues. In this paper, a case of successful continuous lithium treatment for 50 years in a 79-year-old female patient is presented. In this patient, apart from maintaining a euthymic state, long-term lithium treatment also exerted a favorable effect on general health, especially the elimination of viral and other respiratory infections. It is concluded that ultra-long term lithium therapy can enable good professional and psychosocial functioning for many patients, and the possible somatic side effects are manageable.

中文翻译：

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超长期锂剂治疗：重中之重，50年锂剂治疗成功案例

本文讨论了与长期锂治疗相关的基本问题，并介绍了一个成功的 50 年锂治疗案例。锂目前被认为是预防双相情感障碍躁狂和抑郁复发的首选药物。在 1/3 的双相情感障碍患者中，长期锂盐单药治疗可以完全防止情绪异常的复发。已经描述了许多与对锂的良好反应相关的临床和心理社会因素。锂比其他情绪稳定剂更有效，其长期治疗效果明显超过它们。锂还具有抗自杀、免疫调节和神经保护作用。与长期锂治疗相关的主要问题包括肾脏、甲状腺和可能的认知问题。在本文中，介绍了一名 79 岁女性患者成功连续锂治疗 50 年的案例。在该患者中，除了保持心境正常外，长期锂治疗还对整体健康产生了有利影响，尤其是消除了病毒和其他呼吸道感染。结论是，超长期锂疗法可以为许多患者提供良好的专业和社会心理功能，并且可能的躯体副作用是可控的。