Lithium carbonate prophylaxis of alcoholism: its time has come.

To the Editor.— I was delighted to see the publication by Fawcett et al1in the March 1987 issue of thearchivesas a significant addition to the already noticeabie,2,3although still controversial, literature demonstrating beneficial effects of lithium carbonate therapy for alcoholism. In their report, therapeutic serum levels were associated with better outcome over and above the behavioral compliance effect, ie, low levels. Furthermore, Fawcett et al found no evidence that depressed alcoholics showed a better treatment response than nondepressed alcoholics or that lithium carbonate had any significant impact on the mood or social adjustment of alcoholics. Thus, the authors concluded that "lithium carbonate seems to have a beneficial effect on drinking behavior, not necessarily related to the treatment of affective symptoms." The above conclusion is congruent with the data but is not exclusive and not without at least one point of contention, ie, Fawcett and colleagues