Lithium affects nerve excitation, synaptic transmitter and neuronal metabolism. These effects may be produced by alteration of ions transport or distribution, by inhibition of adenyl cyclase mediated responses or by more direct interference with neuronal metabolism. Which of these effects is responsible for the therapeutic benefit in mania, if any, is still unknown. This state of ignorance is directly related to conflicting interpretations and incomplete understanding of the manic state itself.
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