Barry Blackwell’s reply to Janusz Rybakowski’s comment


Barry Blackwell’s reply to Janusz K. Rybakowski’s comment

Dr. Rybakowski’s comments on the “Lithium Controversy” are especially welcome and enlightening, informed as they are by forty five years of devoted, skillful and rewarding research and study.

For me, it was particularly interesting that among Janusz’s first patients was a female physician who had suffered three depressive (sic) episodes and remained asymptomatic for the duration of his own career – a curious echo of Mogens Schou’s prescient experience with his brother – a rumor that caused Blackwell and Shepherd to unfairly question his scientific objectivity.

This also makes me wonder if Dr. Rybakowski’s cohort of 79 patients, observed for 10 years, of which between a quarter and a third were “excellent responders” with “Kraeplinian characteristics”, may also have included a few with recurrent unipolar depression without manic episodes. If so, this may confirm Schou’s late life interest in possible subtle diagnostic indications for a successful outcome.

The serendipitous finding of an antiviral effect of lithium is a well-deserved bonus for what Claude Bernard described as the “well-prepared mind”. Lithium has a long history of unexpected and unproven claims as a panacea, but this time a novel indication is supported by controlled research.                      

We can all look forward with anticipation to the results of the international genome-wide association study of lithium response, when I will celebrate the date of its anniversary submission to the Lancet. Even if puzzlingly complex, it may be a final, timely, nail in the coffin of lithium as a “Therapeutic Myth.”

Barry Blackwell

August 27, 2015