Lithium: evidence reconsidered

Moncrieff, Joanna

doi:10.1192/bjp.171.2.113

Cited by 71 publications

(45 citation statements)

References 81 publications

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“…From the wide range of the ARR and the NNT, it appears, however, that only cautious conclusions may be drawn about the possible protective effect of lithium. Also, some patients in the imipramine/placebo group may have become manic by discontinuation of lithium after randomization (Moncrieff 1997). From the study of Nemeroff et al (2001), who compared paroxetine and imipramine with placebo in bipolar depressed patients using lithium, no conclusions can be drawn about a protective effect of lithium, because it was not compared to placebo.…”

Section: Bipolar Disorder Antidepressants and Hypomania Or Mania 235mentioning

confidence: 98%

Bipolar disorder, antidepressants and induction of hypomania or mania. A systematic review

Visser¹,

Mast

2005

The World Journal of Biological Psychiatry

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Section: Bipolar Disorder Antidepressants and Hypomania Or Mania 235mentioning

confidence: 98%

Bipolar disorder, antidepressants and induction of hypomania or mania. A systematic review

Visser¹,

Mast

2005

The World Journal of Biological Psychiatry

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“…However, not all women maintained on lithium therapy during pregnancy gave birth to babies with heart anomalies. The human epidemiological studies coupled with mouse studies promoted a prevailing controversy on whether or not lithium affects cardiogenesis adversely (Cohen et al, 1994;Moore, 1995;Loebstein and Koren, 1997;Moncrieff, 1997;Gagliardi and Krishnan, 2003;Harris et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

Early temporal‐specific responses and differential sensitivity to lithium and Wnt‐3A exposure during heart development

Manisastry

Han

Linask

2006

Developmental Dynamics

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Members of both Wnt and bone morphogenetic protein (BMP) families of signaling molecules are important in heart development. We previously demonstrated that ␤-catenin, a key downstream intermediary of the canonical Wnt signaling pathway, delineates the dorsal boundary of the cardiac compartments in an anteroposterior progression. We hypothesized the progression involves canonical Wnt signaling and reflects development of the primary body axis of the embryo. A similar anteroposterior signaling wave leading to cardiac cell specification involves inductive signaling by BMP-2 synthesized by the underlying endoderm in anterior bilateral regions. Any molecule that disrupts the normal balance of Wnt and BMP concentrations within the heart field may be expected to affect early heart development. The canonical Wnt signaling step mimicked by lithium involves inactivation of glycogen synthase kinase-3␤ (GSK-3␤; Klein and Melton [1996] Proc. Natl. Acad. Sci. U. S. A. 93:8455-8459). We show that lithium, Wnt-3A, and an inhibitor of GSK-3␤, SB415286, affect early heart development at the cardiac specification stages. We demonstrate that normal expression patterns of key signaling molecules as Notch-1 and Dkk-1 are altered in the anterior mesoderm within the heart fields by a one-time exposure to lithium, or by noggin inhibition of BMP, at Hamburger and Hamilton (HH) stage 3 during chick embryonic development. The severity of developmental defects is greatest with exposure to lithium or Wnt-3A at HH stage 3 and decreases at HH stage 4. Taken together, our results demonstrate that there are temporal-specific responses and differential sensitivities to lithium/Wnt-3A exposure during early heart development.

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“…An analysis of the duration of hospitalisation for acute mania by Keck, comparing lithium and valproate monotherapy and lithium/carbamazepine combination treatment was clearly in favour of valproate monotherapy and lithium/carbamazepine combination treatment (Keck et al 1996). However, a recent chart analysis found no statistically significant difference between lithium and valproate as far as the length of stay in hospital is concerned (11.5 ± 6.9 for patients on valproate and 10.3 ± 5.2 days for patients on lithium, respectively) (Moncrieff 1997).…”

Section: Study Situationmentioning

confidence: 98%

Lithium in the acute treatment of bipolar disorders?a stocktaking

Grunze

2003

European Archives of Psychiatry and Clinical Neuroscience

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Before the rise of atypical antipsychotics, lithium used to be the most frequently investigated substance in the acute treatment of bipolar disorders, although studies are not always of the highest methodological standard. Due to the doubt about a sufficient efficacy of lithium expressed in recent years from various sides, and the simultaneous availability of newer treatment alternatives, this paper attempts to make a critical stocktaking of our knowledge about lithium in the acute treatment of bipolar disorders. Aspects concerning the changed disorder concept through the broadening of the bipolar spectrum, together with the available results from controlled and open studies with lithium, are presented and appraised. This shows that lithium should still be seen as an essential, but not the only corner stone in the differentiated treatment of bipolar patients. Provided that it is taken reliably and well-tolerated, lithium represents a first choice treatment, particularly for a classical course of manic-depressive illness (Bipolar I disorder), especially for mild to moderate manic syndromes.However, as antidepressive treatment, lithium should rather not be applied as a monotherapy, particularly in severe bipolar depression, since with the new generation of antidepressants and anticonvulsants well-tolerated and very effective alternatives are available. In combination treatment, lithium should be applied particularly when it has already shown good prophylactic efficacy and/or in patients for whom a high suicide risk must be presumed.

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Lithium: evidence reconsidered

Cited by 71 publications

References 81 publications

Bipolar disorder, antidepressants and induction of hypomania or mania. A systematic review

Bipolar disorder, antidepressants and induction of hypomania or mania. A systematic review

Early temporal‐specific responses and differential sensitivity to lithium and Wnt‐3A exposure during heart development

Lithium in the acute treatment of bipolar disorders?a stocktaking

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