The science and practice of lithium therapy

Abstract

Lithium is a safe and effective agent that should, whenever indicated, be used first-line for the treatment of bipolar disorder. A better understanding of its science alongside strategic management of its plasma levels will ensure both wider utility and improved outcomes.

Obesity and psychiatric disorders: Commonalities in dysregulated biological pathways and their implications for treatment

“…Potentially, suffering from both conditions may increase neuroprogressive pathways and lead to worsening treatment outcomes, relapse or treatment resistance. Adjunct interventions that may be considered include the addition of anti-inflammatory drugs such as COX-2 inhibitors (Muller and Schwarz, 2008) and the TNF antagonist, infliximab (Raison et al, 2013), medications with neuroprotective properties (e.g., antidepressants, mood stabilisers) (Dodd et al, 2013, Malhi et al, 2012, herbs and nutrients with anti-inflammatory and antioxidant properties (e.g., curcumin, resveratrol, omega-3 fatty acids, green tea, n-acetyl cysteine, CoQ10, selenium, zinc, alpha lipoic acid and vitamins such as A, C and E) (Alappat and Awad, 2010, Floyd, 1999, Kim et al, 2008, Lopresti et al, 2012, Scapagnini et al, 2012 and lifestyle changes known to enhance neurogenesis (e.g., sleep hygiene interventions, meditation, yoga, relaxation therapies and exercise) (Doraiswamy and Xiong, 2007, Kiecolt-Glaser et al, 2010, Lopresti et al, 2013.…”

Parameters for Lithium Treatment Are Critical in Its Enhancement of Fracture-Healing in Rodents

“…The lower dose of lithium used in our study is nearly four times lower than the regular maintenance dose for lithium's psychotropic indication in the treatment of bipolar disorder 35 , which may suggest that the lithium levels needed to improve bone-healing come with minimal risk of acute toxicity. Furthermore, while there are clinically major long-term concerns-including hyperparathyroidism, hypothyroidism, and nephrogenic diabetes insipidus-in patients managed with lithium [36][37][38] , these long-term side effects may be less relevant in short-term lithium use for bone-healing.…”

Lithium: The defining element?

“…The real question is whether its brilliance can shine through the diagnostic clouds that eclipse its effects (Malhi, 2013), and the smog of publicity generated by heavily marketed alternative compounds. In making such comparisons between lithium and other putative mood stabilizers, it is important to emphasize lithium's unique additional qualities, in particular its neuroprotective, neurotrophic and antisuicidal actions (Malhi et al, 2012).…”