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This study examined the association of gender on the physical morbidity of individuals likely living with bipolar disorder (BD) using a comprehensive health-related database. It investigated the association between lithium dispensing (a surrogate marker for BD) and other health morbidities, considering age and sex. The cross-sectional study design used the 10 % Schedule of Pharmaceutical Benefits Scheme (PBS) database in Australia for 2022. Medication dispensing, age, and sex were available. A validated algorithm inferred 45 health morbidities from dispensed medicines. Statistical analyses, including logistic regression, assessed the relationship between lithium dispensing, sex, and age with inferred health morbidities. The sample consisted of 1,594,112 individuals aged 10 to over 95 years. A higher proportion of women than men were dispensed lithium (0.33 % vs 0.30 %). Lithium dispensing and age were associated with higher prevalence of inferred morbidities. Women dispensed lithium had a greater physical health burden compared to men, with higher odds of chronic airways diseases, diabetes, ischaemic heart disease/hypertension, inflammation, pain, psychosis, and steroid-responsive diseases. Conversely, women dispensed lithium had lower odds of cardiac arrhythmias and hypothyroidism compared to men. This study provides evidence that individuals with BD, indicated by the dispensing of lithium, experience a relatively higher frequency of physical health morbidities, with women being disproportionally affected compared to men. The findings highlight the need for comprehensive care for people living with BD, particularly women. • Most physical morbidities are more prevalent among individuals with than without bipolar disorder (BD), particularly women. • Women with BD have more respiratory, heart and steroid-responsive diseases, diabetes, inflammation, and pain than men. • Cardiac arrythmia and hypothyroidism are more frequent in men than women with bipolar disorder. • Older adults with BD require effective preventive interventions designed to meet their physical health, especially women. [ABSTRACT FROM AUTHOR]

The article focuses on the treatment of acute mania. Topics discussed icnlude Product Information published by the published by the Australian Therapeutic Goods Administration on the therapeutic effectivness of lithium carbonate for acute mania; its role in reducing the risk of acute lithium toxicity; and clinical practice of the same.

The article describes contributions of John Cade, who recently died, to the field of psychiatry. He studied the effects of lithium carbonate on humans by ingesting lithium himself. He showed that lithium reduced toxicity in manic patients. However, lithium's utility was soon restricted due to its side effects. John Cade's crucial experiments and his conclusions were vindicated with the conclusive demonstration of lithium's efficacy.