Lithium's psychiatric discovery (1949–1970)
Australian psychiatrist John Cade discovered lithium's calming properties accidentally in 1949 while injecting lithium-urine solutions into guinea pigs as part of unrelated research. He published clinical results showing lithium improved mania, but adoption was slow—partly because lithium is a natural element that no company could patent. Danish psychiatrist Mogens Schou championed lithium through rigorous trials over two decades.
The FDA did not approve lithium for bipolar disorder until 1970, more than twenty years after Cade's discovery.
Lithium remains the only medication proven to prevent suicide in mood disorders and is still considered the gold standard for bipolar maintenance therapy, despite being one of the oldest and cheapest psychiatric drugs available.
Lithium illustrates both the promise and the friction of psychiatric drug discovery through serendipity. GLP-1 drugs face a faster path—they are already widely prescribed, well-characterized, and backed by large pharmaceutical companies—but the same fundamental question applies: can observational signals survive the rigor of controlled trials?