Often maximum therapeutic levels necessary in bipolar disorder? The cyclical nature of manic depression has lapses of 3 to sometimes years of "episodes". A daily dose inevitably has an effect on the heart, skin, brain, and especially the kidneys. Once again, I have mentioned before that Dr. Mogens Schou took into consideration the deleterious effect of lithium on the kidneys at a chronic pace and suggested "lithium holidays" to allow kidney clearance. This prophylactic treatment for mental illness may be based on the assumption that once a bipolar always a bipolar, every day, and once a schizophrenic always a schizophrenic every day, once a melancholic, always a melancholic everyday. By analogy, current medical treament may also be applied to headaches treated with *Tylenol* for example: once a headache always a headache, and yet this type of OCT is not given on a prophylactic ideology. I wonder if it is not possible to give meds to bipolars and other mentally ill patients, during only phases of mania, hypomania, depression, psychotic states, etc. and thus spare the chronic and cumulative adverse effects on the body that daily drug can have on the body and mind