Patients receiving lithium therapy have a reduced prevalence of neurological and cardiovascular disorders

Prosser, James M.; Fieve, Ronald R.

doi:10.1016/j.pnpbp.2016.06.006

Cited by 34 publications

(41 citation statements)

References 40 publications

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“…Importantly, our finding that lithium did not elevate the risk of stroke in patients with bipolar disorder is in line with previous clinical reports. 5,6 In prior animal studies, lithium was demonstrated to inhibit the expression of vascular cell adhesion molecule-1, 20 infiltration of macrophages into the atherosclerotic plaque 20 and proliferation and migration of vascular smooth muscle cells. 21 These mechanisms are proposed to contribute to the protective effects of lithium against cerebrovascular diseases.…”

Section: Main Findingsmentioning

confidence: 99%

“…5 However, another recent retrospective chart review did not find a significant association between lithium therapy and the risk of stroke. 6 Despite the evidence that there are associations between the risk of stroke and use of anticonvulsants such as carbamazepine in populations with epileptic disorder, 7,8 data on the risk of stroke following exposure to valproic acid, carbamazepine and lamotrigine specific to patients with bipolar disorder is still lacking. This knowledge gap and safety concerns merit evidence-based research on whether the use of mood stabilisers is more likely to increase the risk of stroke in patients with bipolar disorder.…”

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confidence: 99%

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Mood stabilisers and risk of stroke in bipolar disorder

et al. 2018

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BackgroundResearch on the risk of stroke following the use of mood stabilisers specific to patients with bipolar disorder is limited.AimsIn this study, we investigated the risk of stroke following the exposure to mood stabilisers in patients with bipolar disorder.MethodData for this nationwide population-based study were derived from the Taiwan National Health Insurance Research Database. Among a retrospective cohort of patients with bipolar disorder (n = 19 433), 609 new-onset cases of stroke were identified from 1999 to 2012. A case–crossover study design utilising 14-day windows was applied to assess the acute exposure effect of individual mood stabilisers on the risk of ischaemic, haemorrhagic and other types of stroke in patients with bipolar disorder.ResultsMood stabilisers as a group were significantly associated with the increased risk of stroke in patients with bipolar disorder (adjusted risk ratio, 1.26; P = 0.041). Among individual mood stabilisers, acute exposure to carbamazepine had the highest risk of stroke (adjusted risk ratio, 1.68; P = 0.018), particularly the ischaemic type (adjusted risk ratio, 1.81; P = 0.037). In addition, acute exposure to valproic acid elevated the risk of haemorrhagic stroke (adjusted risk ratio, 1.76; P = 0.022). In contrast, acute exposure to lithium and lamotrigine did not significantly increase the risk of any type of stroke.ConclusionsUse of carbamazepine and valproic acid, but not lithium and lamotrigine, is associated with increased risk of stroke in patients with bipolar disorder.Declaration of interestNone.

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Section: Main Findingsmentioning

confidence: 99%

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confidence: 99%

Mood stabilisers and risk of stroke in bipolar disorder

et al. 2018

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“…Zuletzt ist zu erwähnen, dass Lithium nach neueren Erkenntnissen auch hinsichtlich anderer Erkrankungen positive Effekte aufweist und damit die Schwelle des Einsatzes gegebenenfalls noch niedriger anzusetzen ist: Prosser und Fieve [32] berichten 2016 von einer reduzierten Prävalenz kardiovaskulärer und neurologischer Erkrankungen bei Patienten unter Lithiumbehandlung. Zur Demenz indes herrscht eine Uneinigkeit in der Literatur.…”

Section: Einordnung Der Ergebnisseunclassified

„Lithium in der Behandlung der Altersdepression. Was spricht dafür, was dagegen?“

Stühler

Quante

2018

Fortschr Neurol Psychiatr

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Zusammenfassung Anliegen Die Lithiumaugmentation ist eine der Behandlungsoptionen bei therapieresistenter Depression. In diesem Review soll die Studienlage zu der Anwendung von Lithium im höheren Lebensalter bei unipolarer Depression zusammengefasst werden. Methode Es wurde eine selektive Literaturrecherche in PubMed durchgeführt. Es konnten insgesamt 15 relevante Artikel (Plazebokontrollierte Studien und Übersichtsarbeiten) miteinbezogen werden. Ergebnisse: Sowohl die klinischen Studien als auch die Reviews sprechen sich positiv für die Lithiumaugmentation im Alter aus. Die Remissionsraten und das Ansprechen auf das Lithium allgemein sind sehr hoch. Nierenschäden als gefürchtete Nebenwirkungen treten nur selten auf. Auch über längere Anwendung hinaus zeigt sich das Lithium als wirksam und verträglich, wobei Laborkontrollen engmaschiger durchgeführt werden sollten. Schlussfolgerung Lithium präsentiert sich als wirksames Medikament bei therapieresistenter unipolaren Altersdepression. Im klinischen Alltag ist der Einsatz bei fehlender Kontraindikation zu empfehlen.

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“…Relevant to this discussion is a report that indicated that patients receiving lithium therapy (i.e. higher doses for conditions such as bipolar disorders) have a reduced prevalence of both neurological and cardiovascular disorders [45].…”

Section: Lithium Salts and Dementiamentioning

confidence: 99%

Would Adding Low Doses of Lithium Salts and/or Prebiotic Fibre Interventions to an Effective Exercise Protocol Further Enhance Retention of Cognitive Integrity? Potential for Preventing Loss of Cognition with Aging Using Combinations of Low Cost Regimens

Hart¹

2018

JBiSE

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It is clear that loss of cognition is becoming epidemic in our aging society. Onset of dementia and diseases such as Alzheimer's are very prevalent and the prognosis is not optimistic that numbers will decrease in the coming decades. Thus, this epidemic is impacting the quality of life of a large number of people, primarily females, as well as the health care systems of many countries. Of relevance is the fact that large clinical trials of candidate drugs to treat these conditions have not been overwhelming successes, indicating that we may need to take new directions or focus on prevention. One conservative approach in this regard has been the use of exercise protocols to both retain cognition and inhibit progression of loss. With the optimization of exercise protocols, it may be time to step back and ask "how can these successes be augmented to further inhibit risk and stabilize loss early in the development of these conditions?" An example of how this could be approached is via supplementation with low doses of minerals such as lithium salts, or supplementation of the diet with prebiotics in patients with obesity and metabolic syndrome. Regarding the former, recent epidemiological studies have indicated that the content of Li in the drinking water is associated with lower incidences of cognitive diseases/conditions. While not definitive, such clues may warrant performing controlled studies using low doses of lithium salts plus exer- cise to further optimize impact on retention of cognition in those at risk, or those with early disease. Similarly, patients with obesity are at higher risk to develop dementia, and prebiotics can correct some of the metabolic derangements associated with the microbiome in such patients to impact risk. Thus, multiple low cost interventions plus exercise could further enhance retention of cognitive integrity in specific populations.

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Patients receiving lithium therapy have a reduced prevalence of neurological and cardiovascular disorders

Cited by 34 publications

References 40 publications

Mood stabilisers and risk of stroke in bipolar disorder

Mood stabilisers and risk of stroke in bipolar disorder

„Lithium in der Behandlung der Altersdepression. Was spricht dafür, was dagegen?“

Would Adding Low Doses of Lithium Salts and/or Prebiotic Fibre Interventions to an Effective Exercise Protocol Further Enhance Retention of Cognitive Integrity? Potential for Preventing Loss of Cognition with Aging Using Combinations of Low Cost Regimens

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