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**Enlicitide + lithium carbonate** is an investigational combination therapy comprised of enlicitide (a novel oral macrocyclic peptide PCSK9 inhibitor) and lithium carbonate (an established mood stabilizer/lithium salt) administered orally. Enlicitide acts by binding to PCSK9 and inhibiting its interaction with LDL receptors, resulting in increased clearance of LDL cholesterol from the blood and reduction of major atherogenic lipids[1][2][3][4][6]. Lithium carbonate is a small molecule drug primarily used for bipolar disorder, with a well-defined mechanism of action involving modulation of neurotransmitter signaling (including inhibition of inositol monophosphatase), but in this combination setting, it is coadministered in a clinical trial to assess potential pharmacokinetic, pharmacodynamic, or drug interaction effects[5]. No specific synergy or clinical indication for the coadministration of enlicitide and lithium carbonate beyond investigational safety studies is yet established. The combination is under phase 1 evaluation.
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