Cade was originally investigating the hypothesis that mania was related to urea, and using lithium citrate as part of an animal experiment. However, his use of careful controls in his experiments revealed that the lithium salt had a calming effect by itself. A small-scale trial on humans revealed that lithium had a powerful effect on mania in people.
Early results were highly promising, but the toxicity of lithium led to several deaths of patients undergoing lithium treatment. This prevented its widespread adoption in psychiatry for some years, particularly in the United States, where its use was banned.
The biologically active element in lithium carbonate is the lithium cation, Li+. It is conjectured to act on over-active receptors in the cell membranes of neurons.
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