Lithium and risk of cardiovascular disease, dementia and venous thromboembolism

Ponzer, Katja; Millischer, Vincent; Schalling, Martin; Gissler, Mika; Lavebratt, Catharina; Backlund, Lena

doi:10.1111/bdi.13300

Cited by 8 publications

(9 citation statements)

References 47 publications

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“…The use of lithium therapy has a protective effect on reducing the risk of developing dementia, which is consistent with the conclusions of some studies [34‒36], which concluded that the prevalence of dementia is reduced in patients who take lithium every day for a while compared to those who do not undergo lithium therapy and that regular lithium therapy may help patients to resist the onslaught of dementia. However, the results do not support the use of lithium to prevent dementia as they are inconsistent with some studies [18, 21, 37] that concluded that patients treated with lithium had a higher risk of being diagnosed with dementia compared to patients who did not receive lithium therapy [18], and could not prove that lithium therapy reduces the risk of dementia [37] or that lithium has a preventive effect on the development of dementia [21]. The possible reason for the discrepancy is the influence of other confounding factors in the study.…”

Section: Discussionmentioning

confidence: 94%

Lithium Therapy’s Potential to Lower Dementia Risk and the Prevalence of Alzheimer’s Disease: A Meta-Analysis

Lu,

Lv,

Liu

et al. 2024

Eur Neurol

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Introduction: Dementia is a neurodegenerative disease with insidious onset and progressive progression, of which the most common type is Alzheimer's disease (AD). Lithium, a trace element in the body, has neuroprotective properties. However, whether lithium can treat dementia or AD remains a highly controversial topic. Therefore we conducted a meta-analysis. Methods: A systematic literature review was conducted in PubMed, Embase, and Web of Science. Comparison of the effects of lithium on Alzheimer's disease or dementia in terms of use, duration, and dosage, and meta-analysis to test whether lithium therapy is beneficial in ameliorating the onset of dementia or Alzheimer's disease. Sensitivity analyses were performed using a stepwise exclusion method. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of included studies. We determined the relative risk (RR) between patient groups using a random effects model. Results: A total of seven studies were included. The forest plot results showed that taking lithium therapy reduced the risk of Alzheimer's disease (RR 0.59, 95% CI: 0.44-0.78), and is also protective in reducing the risk of dementia (RR 0.66, 95% CI: 0.56-0.77). The duration of lithium therapy was able to affect the dementia incidence (RR 0.70, 95% CI: 0.55-0.88); however, it is unclear how this effect might manifest in AD. It's also uncertain how many prescriptions for lithium treatment lower the chance of dementia development. Conclusion: The duration of treatment and the usage of lithium therapy seem to lower the risk of AD and postpone the onset of dementia.

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Section: Discussionmentioning

confidence: 94%

Lithium Therapy’s Potential to Lower Dementia Risk and the Prevalence of Alzheimer’s Disease: A Meta-Analysis

Lu,

Lv,

Liu

et al. 2024

Eur Neurol

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“…The same authors, analysing a cohort of almost 20,000 BD patients, found that lithium and lamotrigine did not increase the risk of stroke, whereas such a risk was higher with carbamazepine and valproate use (Chen et al, 2019). More recently, Ponzer et al (2023) showed that the use of lithium reduces the risk of cardiovascular and cerebrovascular disorders, while it increases such risks in relation to pulmonary artery embolism.…”

Section: { Review Of Key Literature From 2019 To 2023 On the Use Of L...mentioning

confidence: 99%

Lithium in mood disorders – an update

Rybakowski

2023

fpn

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in pregnancy and the postpartum period, the prevalence of lithium use and attitudes of psychiatrists towards it, and the incentives for broader lithium administration. Conclusions. The studies published between 2019 and 2023 confirmed the significant role of lithium in preventing the recurrences of mood disorders and as a therapeutic drug in acute episodes of the illness. The potentiation of antidepressants in treatment-resistant depression may constitute the second indication for lithium administration after the prevention of bipolar disorder. The optimal lithium concentration for prophylactic purposes is 0.6-0.8 mmol/l. The most important among the advant ages of long-term use of the drug are suicide prevention and a possible anti-dementia effect, but also a favourable effect on the functioning of many body systems. Adverse side effects of long-term lithium administration, including its influence on kidneys, can be minimised by appropriate application and drug monitoring. The use of lithium in pregnancy and the postpartum period seems relatively safe and therapeutically efficient. Despite the many advantages of the use of lithium in affective disorders, lithium is still underutilised, so that the therapeutic potential of the drug is not fully exploited. STRESZCZENIECel. Celem pracy jest przedstawienie najważniejszych prac klinicznych, opublikowanych w latach 2019-2023, dotyczących stosowania litu w chorobach afektywnych. Przegląd piśmiennictwa. Dokonano wyboru i omówienia piśmiennictwa, które dotyczyło takich zagadnień, jak skuteczność profilaktycznego i leczniczego działania AbSTRACTObjectives. The paper aims to present the most important clinical research on lithium in mood disorders, published between 2019 and 2023. Literature review. The bibliography was selected and discussed across such topics as prophylactic and therapeutic lithium efficacy in mood disorders, therapeutic lithium concentrations and preparations, advantages and adverse side effects of long-term lithium administration, clinical factors connected with the efficacy of long-term lithium administration, the use of lithium Review article / Artykuł przeglądowy Lithium in mood disorders -an updateLit w chorobach afektywnych -aktualizacja

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“…However, because elderly subjects are often excluded from randomized clinical trials, studies focused on the treatment of bipolar disorder in older age are lacking and the information is mainly based on data derived from mixed age populations [48,49]. A growing attention is being given to a subset of patients with bipolar disorder, defined "older age bipolar disorder" (OABD), i.e., bipolar patients aged 50 years and over with prevalent cognitive deficits, increased risk of dementia, impaired psychosocial functioning, frequent physical comorbidities, and premature death [50,51]. In a double-blind, randomized, controlled trial in elderly patients with bipolar disorder, lithium was more effective than valproate in reducing manic symptoms during a 9 week follow-up and both drugs were similarly well tolerated [52].…”

Section: Myth 1: Lithium Is Not the First Choice For Treating Patient...mentioning

confidence: 99%

“…Although caution is required when prescribing lithium to subjects with cardiovascular diseases, such as arrythmias and QT prolongation, especially with concomitant electrolyte imbalances [53], Ponzer et al [51] found a lower risk for cardiovascular and cerebrovascular diseases in BD patients receiving lithium.…”

Section: No Drug Has Antisuicidal Effects Lithium Has An Antisuicidal...mentioning

confidence: 99%

Facts and myths about the use of lithium for bipolar disorder in routine clinical practice: an expert consensus paper

Fiorillo,

Sampogna,

Albert

et al. 2023

Ann Gen Psychiatry

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Background Bipolar disorder is one of the most burdensome severe mental disorders, characterized by high levels of personal and social disability. Patients often need an integrated pharmacological and non-pharmacological approach. Lithium is one of the most effective treatments available not only in psychiatry, but in the whole medicine, and its clinical efficacy is superior to that of other mood stabilizers. However, a declining trend on lithium prescriptions has been observed worldwide in the last 20 years, supporting the notion that lithium is a ‘forgotten drug’ and highlighting that the majority of patients with bipolar disorder are missing out the best available pharmacological option. Based on such premises, a narrative review has been carried out on the most common “misconceptions” and “stereotypes” associated with lithium treatment; we also provide a list of “good reasons” for using lithium in ordinary clinical practice to overcome those false myths. Main text A narrative search of the available literature has been performed entering the following keywords: “bipolar disorder”, “lithium”, “myth”, “mythology”, “pharmacological treatment”, and “misunderstanding”. The most common false myths have been critically revised and the following statements have been proposed: (1) Lithium should represent the first choice for the treatment of patients with bipolar disorder; (2) lithium treatment is effective in different patients’ groups suffering from bipolar disorder; (3) Drug–drug interaction risk can be easily managed during lithium treatment; (4) The optimal management of lithium treatment includes periodical laboratory tests; (5) Slow-release lithium formulation has advantages compared to immediate release formulation; (6) Lithium treatment has antisuicidal properties; (7) Lithium can be carefully managed during pregnancy. Conclusions In recent years, a discrepancy between evidence-based recommendations and clinical practice in using lithium treatment for patients with bipolar disorder has been highlighted. It is time to disseminate clear and unbiased information on the clinical efficacy, effectiveness, tolerability and easiness to use of lithium treatment in patients with bipolar disorder. It is necessary to reinvigorate the clinical and academic discussion about the efficacy of lithium, to counteract the decreasing prescription trend of one of the most effective drugs available in the whole medicine.

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Lithium and risk of cardiovascular disease, dementia and venous thromboembolism

Cited by 8 publications

References 47 publications

Lithium Therapy’s Potential to Lower Dementia Risk and the Prevalence of Alzheimer’s Disease: A Meta-Analysis

Lithium Therapy’s Potential to Lower Dementia Risk and the Prevalence of Alzheimer’s Disease: A Meta-Analysis

Lithium in mood disorders – an update

Facts and myths about the use of lithium for bipolar disorder in routine clinical practice: an expert consensus paper

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