Should lithium be first-line therapy for acute mania?

Lithium is an effective treatment for acute manic episodes in bipolar disorder, a Cochrane review has confirmed.
However, it is no better than other currently recommended first-line treatments.
In fact, the researchers from the University of Oxford, UK, say the most effective drug may be olanzapine, but more research is needed to confirm this.
Their study analysed 36 randomised controlled trials that included 4220 patients with bipolar disorder.