First agent shown to be effective in maniac phase of BPD is

.lithium was the frst agent to be used for mania it has mood stabilizing propey it was introduced by John F Cade it is liver friendly drug it has to be introduced in caution with renal derangements it can cause of hypothyroidim it should be given with caution with ACE inhibitors, NSAIDS, Angiotensin receptor antagonists it has a narrow thereupatic index the optimal level of lithium in blood need for reduction of acute symptoms is 0.8-1.2meq/l when taken in increased amount , it may result in lithium toxicity hemodialysis is the treatment for lithium toxicity