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Dr. Peter E. Stokes, a Cornell endocrinologist and psychiatrist and a pioneer in the use of lithium to treat manic depression, has died in Manhattan. He was 78.

He had been hospitalized since November, and a cause of his Jan. 22 death was not determined, his family said.

Dr. Stokes, who taught for four decades at Cornell, qualified first in endocrinology before training in psychiatry during the 1960s. After early research in anxiety, through the field of neuroendocrinology, he turned to the study of depression.

In 1965, at the Payne Whitney Clinic in Manhattan, he and other scientists began to investigate the effects of lithium, in the form of a salt, in controlling bipolar disease and manic depression. The encouraging results of the study were published in The Lancet, a British medical journal, in 1971. Lithium was approved for use in the United States in 1970.

Dr. Jack Barchas, chairman of Cornell’s department of psychiatry, said Dr. Stokes’ studies had been “very important in working out lithium dosages and the best treatment regimes.”

He added, “Because of people like Peter, lithium remains the principal treatment for mania and for many patients the most effective.”

In other areas of interest, Dr. Stokes, who also trained in nuclear medicine, studied selective serotonin reuptake inhibitors in the treatment of depression, and the effects of alcohol on perception of time.

Dr. Stokes was appointed an instructor in medicine at Cornell Medical College in 1957 and remained there for his entire career, retiring as an emeritus professor of medicine and psychiatry in 1998.