Lithium or an atypical antipsychotic drug in the management of treatment-resistant depression: a systematic review and economic evaluation

Edwards, Steven J; Hamilton,; Nherera, L.; Trevor, Nicola

doi:10.3310/hta17540

Cited by 56 publications

(52 citation statements)

References 153 publications

(309 reference statements)

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“…64,65 These comparisons suggest that increased brain AA metabolism may be associated with the manic phase of BD, and that stimulating AA metabolism may be associated with a switch of depression to mania with certain antidepressants. Indeed, co-administration of lithium, which depresses AA metabolism in rats, is recommended when fluoxetine is administered; 66 it might dampen the untoward AA upregulation of the SSRI. In mice, SSRIs increased inflammatory markers tumor necrosis factor (TNF)-alpha, interferon (IFN)-gamma and p11 in the frontal cortex.…”

Section: Pharmacotherapy In Bd: Anti-inflammatory and N-3 Pufa Agentsmentioning

confidence: 99%

Reconsidering Dietary Polyunsaturated Fatty Acids in Bipolar Disorder: A Translational Picture

Saunders

Ramsden

Sherazy

et al. 2016

J. Clin. Psychiatry

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Inflammation is an important mediator of pathophysiology in bipolar disorder (BD). The omega (n)-3 and omega (n)-6 polyunsaturated fatty acid (PUFA) metabolic pathways participate in several inflammatory processes, and have been linked through epidemiological and clinical studies to BD and its response to treatment. We review the proposed role of PUFA metabolism in neuroinflammation, modulation of brain PUFA metabolism by antimanic medications in rodent models, and anti-inflammatory pharmacotherapy in BD and in major depressive disorder (MDD). Though the convergence of findings between pre-clinical and post-mortem clinical data is compelling, we investigate why human trials of PUFA as treatment are mixed. We view the biomarker and treatment study findings in light of the evidence for the hypothesis that arachidonic acid (AA) hypermetabolism contributes to BD pathophysiology, and propose that a combined high n-3 plus low n-6 diet should be tested as an adjunct to current medication in future trials.

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Section: Pharmacotherapy In Bd: Anti-inflammatory and N-3 Pufa Agentsmentioning

confidence: 99%

Reconsidering Dietary Polyunsaturated Fatty Acids in Bipolar Disorder: A Translational Picture

Saunders

Ramsden

Sherazy

et al. 2016

J. Clin. Psychiatry

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“…Lithium carbonate has been used as an invaluable drug to cure bipolar disorders and manic-depressive illness for more than 60 years (Grunze et al 2010;Calkin and Alda 2012;Vieta and Valenti 2013). Moreover, it was reported that this drug used as chronic treatment to prevent development of Alzheimer's disease (Forlenza et al 2011) and for treatment of refractory depression (Edwards et al 2013;Cleare et al 2015). During treatment of bipolar disorders, the prolonged exposure to Li exhibits toxic effects on several biological systems (McCartney et al 2014;Albert et al 2014).…”

Section: Introductionmentioning

confidence: 99%

A renoprotective role of chitosan against lithium-induced renal toxicity in rats

Aboulthana

Ibrahim

2018

Bull Natl Res Cent

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Background: Lithium (Li) is considered as the first therapeutic line for treatment of bipolar affective disorders and manic-depressive illness. Renal toxicity can be categorized as the most common undesirable side effect of Li therapy. Therefore, the present study aimed to reveal efficiency of chitosan (CS) as a natural chelator against renal toxicity induced as a result of Li injection. During current experiment, the renal functions (urea, creatinine, blood urea nitrogen (BUN), uric acid and total protein) were determined in serum samples. The urinary excretion of N-acetyl-β-Dglucosaminidase (NAG) was assayed through measuring its level in urine samples. Moreover, markers of the oxidative stress (superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), reduced glutathione (GSH) and lipid peroxidation product (LPO)) were assessed in renal tissues. In addition, histopathological and ultrastructural examinations were carried out in that tissue. Results: It was found that Li injection caused significant (P < 0.05) elevation in serum urea, creatinin and BUN levels associated with decline in uric acid and T. protein. Moreover, Li increased the urinary excretion of NAG significantly (P < 0.05). Administration of CS orally restored levels of these measurements to normalcy in CS pre-treated group through lowering urea, creatinin, BNU levels and urinary excretion of NAG with enhancing uric acid and T. protein levels. On the other hand, it was found that Li caused significant (P < 0.05) elevation in the LPO level associated with decline in activity of the antioxidant system in the renal tissues. Likewise, it caused severe alterations in the renal levels at histopathological and ultrastructural levels. The treatment with CS reduced the renal LPO associated with stimulating the antioxidant system through increasing levels of SOD, CAT, GPx and GSH in addition to its beneficial role against the histopathological abnormalities. Conclusions: The CS exhibited promising role in the protection against the oxidative stress and renal toxicity induced as a result of Li injection.

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“…9 Moreover, augmentation with lithium may also be more cost-effective than augmentation with atypical antipsychotics. 10 Lithium was also confirmed as a potent antisuicidal drug in a recent meta-analysis 11 -a finding that is particularly relevant here given our patient's family history. Lithium should be used at blood levels between 0.5 and 0.8 mmol/L, and sparse data suggest that if efficient, it should be maintained for a period of at least 1 year to avoid recurrence.…”

mentioning

confidence: 65%

Add-on lithium for the treatment of unipolar depression: Too often forgotten?

Jollant

2015

jpn

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Lithium or an atypical antipsychotic drug in the management of treatment-resistant depression: a systematic review and economic evaluation

Cited by 56 publications

References 153 publications

Reconsidering Dietary Polyunsaturated Fatty Acids in Bipolar Disorder: A Translational Picture

Reconsidering Dietary Polyunsaturated Fatty Acids in Bipolar Disorder: A Translational Picture

A renoprotective role of chitosan against lithium-induced renal toxicity in rats

Add-on lithium for the treatment of unipolar depression: Too often forgotten?

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