In this review the authors investigate the use of lithium therapy in patients with a schizophrenic psychosis. Analysis of 12 controlled and 14 uncontrolled and case studies shows that lithium in all studies was superior to placebo and especially useful as additive medication in case of poor response to neuroleptics. Moreover lithium addition seems to offer the possibility to decrease the neuroleptic dose. There is perhaps an indication for lithium as monotherapy in case of therapy resistancy for neuroleptics. Lithium, also in combination with neuroleptics, appeared to be a relatively safe drug for the target group. Practical and theoretical implications of experiences are discussed.