An update on the use of lithium carbonate in aggressive children and adolescents with conduct disorder.

Although some knowledge has been gained concerning indications, therapeutic dose range, and safety of lithium in aggressive children and adolescents with conduct disorder, only a few double-blind and placebo-controlled studies have been conducted. A survey of the literature indicates that the four major studies are in disagreement as to lithium's ability to reduce aggression. Differences in duration of treatment, subject status, and subject selection may account for the differences in results. Methodologic issues that need to be addressed in future clinical trials involving this population are commented on and include the measurement and subtyping of aggression and assessment of psychosocial factors. Such research is needed to establish not only the role and efficacy of lithium in the treatment of aggression but also the effectiveness of this psychoactive agent in clinical practice.