The therapeutic mechanisms of lithium for treating bipolar mood disorder remain poorly understood. Recent studies demonstrate that lithium has neuroprotective actions against a variety of insults. Here, we studied neuroprotective effects of lithium against excitotoxicity in cultured cerebral cortical neurons. Glutamate-induced excitotoxicity in cortical neurons was exclusively mediated by NMDA receptors. Pre-treatment of cortical neurons with LiCl time-dependently suppressed excitotoxicity with maximal protection after 6 days of pretreatment. Signi®cant protection was observed at the therapeutic and subtherapeutic concentration of 0.2±1.6 mM LiCl with almost complete protection at 1 mM. Neuroprotection was also elicited by valproate, another major mood-stabilizer. The neuroprotective effects of lithium coincided with inhibition of NMDA receptor-mediated calcium in¯ux. Lithium pre-treatment did not alter total protein levels of NR1, NR2A and NR2B subunits of NMDA receptors. However, it did markedly reduce the level of NR2B phosphorylation at Tyr1472 and this was temporally associated with its neuroprotective effect. Because NR2B tyrosine phosphorylation has been positively correlated with NMDA receptor-mediated synaptic activity and excitotoxicity, the suppression of NR2B phosphorylation by lithium is likely to result in the inactivation of NMDA receptors and contributes to neuroprotection against excitotoxicity. This action could also be relevant to its clinical ef®cacy for bipolar patients. Keywords: bipolar disorder, excitotoxicity, lithium, neuroprotection, NMDA receptor, phosphorylation. Lithium has been one of the primary drugs used to treat bipolar mood disorder as it was introduced into psychiatry over half a century ago. The therapeutic effect of lithium requires long-term treatment, occurs at a narrow dose-range and is not immediately reversed after discontinuation of the drug. The therapeutic mechanisms of lithium are still unclear; however, some prominent molecular and cellular actions of this drug have been identi®ed. These include its ability to inhibit key intracellular signaling kinases and phosphatases such as glycogen synthase kinase-3 and inositol monophosphatase and to affect transcriptional activity and gene expression (for review see Jope 1999; Manji and Lenox 2000;Phiel and Klein 2001). However, it remains unclear as to whether these actions are related to the clinical ef®cacy of this drug, especially considering that many of these effects are acute and occur at supratherapeutic dose ranges.