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Although lithium carbonate is a mainstay in the treatment of mood disorders, especially bipolar illness, its use is attended by a high incidence of side efiects. Physical side efiects are usually addressed efiectively by the psychiatrist, but neuropsychological side efiects often go untreated and thus may contribute to a high rate of drug non-compliance. Evidencefiom a variety of sources indicates that the major neuropsychological efiect of lithium is a generalized psychomotor slowing that manifests itselfin subjective complaints of impaired thinking ability, a sense of lethargy, and memory dysjhction. The objective techniques of neuropsychological testing have begun to dissect the discrete aspects of cognition and memory that may be impaired by lithium. Although the neuropsychological deficits of hypothyroidism have not yet been subjected to detailed study, the deficits caused by lithium appear to be consistent with those encountered in patients with hypothyroidism, whether overt or subclinical. Relevant to this comparison is the fact that lithium is a potent antithyroid drug. For these reasons, it is just$ed to state as a hypothesis that at least some of the neuropsychological de$cits caused by lithium are attributable to their antithyroid effern. This hypothesis provides directions for fiture research in this area and has potentially important implications fir treating the neuropsychological side @ern of lithium . Depression 2:241-251 (1 99411 995). 0 199s Wdq-Lks, Inc.

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