Invited commentary to Professor Belmaker's letter on lithium treatment for bipolar disorder.

This document is an invited commentary in response to a letter by Professor RH Belmaker regarding the use of lithium as a treatment for bipolar disorder. The authors express gratitude for the opportunity to engage in scholarly conversation and emphasize the importance of robust discussion in expanding knowledge and understanding of complex issues. They agree with Belmaker that there are other treatment options available, but maintain that lithium should be prioritized as the primary maintenance treatment for bipolar type I disorder due to its demonstrated efficacy and relatively favorable side effect profile. The authors also address concerns about the lack of understanding of lithium's mechanism of action and argue that this should not diminish its clinical value. They call for increased emphasis on the evidence supporting lithium's efficacy and the dissemination of knowledge on monitoring and managing side effects to counteract the declining trend in its use for bipolar disorder. [Extracted from the article]