What an endocrinologist should know for patients receiving lithium therapy

Haissaguerre, Magalie; Vantyghem, Marie-Christine

doi:10.1016/j.ando.2022.01.001

Cited by 9 publications

(6 citation statements)

References 47 publications

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“…In the group of 66 patients receiving lithium for 10-44 years, we did not observe differences in thyroid function between those taking lithium for less or more than twenty years (Kraszewska et al 2015). The presence of hypothyroidism and/or large goiter during lithium therapy should not be the cause of lithium discontinuation but is the indication for thyroxine treatment, the dose could be consulted with an endocrinologist (Haissaguerre and Vantyghem 2022). Lithium therapy can be also associated with increased blood calcium and parathormone (PTH) levels (McKnight et al 2012).…”

Section: Adverse Somatic Effects Of Lithium Administrationmentioning

confidence: 69%

Effectiveness of ultra-long-term lithium treatment: relevant factors and case series

Ferensztajn-Rochowiak,

Lewitzka,

Chłopocka-Woźniak

et al. 2024

Int J Bipolar Disord

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Background The phenomenon of preventing the recurrences of mood disorders by the long-term lithium administration was discovered sixty years ago. Such a property of lithium has been unequivocally confirmed in subsequent years, and the procedure makes nowadays the gold standard for the pharmacological prophylaxis of bipolar disorder (BD). The efficacy of lithium prophylaxis surpasses other mood stabilizers, and the drug has the longest record as far as the duration of its administration is concerned. The continuation of lithium administration in case of good response could be a lifetime and last for several decades. The stability of lithium prophylactic efficacy in most patients is pretty steady. However, resuming lithium after its discontinuation may, in some patients, be less efficient. Main body In the article, the clinical and biological factors connected with the prophylactic efficacy of long-term lithium administration are listed. Next, the adverse and beneficial side effects of such longitudinal treatment are presented. The main problems of long-term lithium therapy, which could make an obstacle to lithium continuation, are connected with lithium’s adverse effects on the kidney and, to lesser extent, on thyroid and parathyroid functions. In the paper, the management of these adversities is proposed. Finally, the case reports of three patients who have completed 50 years of lithium therapy are described. Conclusions The authors of the paper reckon that in the case of good response, lithium can be given indefinitely. Given the appropriate candidates for such therapy and successful management of the adverse effects, ultra-long term lithium therapy is possible and beneficial for such patients.

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Section: Adverse Somatic Effects Of Lithium Administrationmentioning

confidence: 69%

Effectiveness of ultra-long-term lithium treatment: relevant factors and case series

Ferensztajn-Rochowiak,

Lewitzka,

Chłopocka-Woźniak

et al. 2024

Int J Bipolar Disord

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“…This indicates that thyroid autoimmunity, including its association with MDD, may be linked to alterations in the regulation of the mitochondrial melatonergic pathway in the thyroid gland. As noted, autoimmune thyroiditis and hypothyroidism are not uncommon in bipolar disorder patients treated with lithium [142], overlapping thyroid autoimmune processes with wider mood presentations and their treatment.…”

Section: Autoimmunity and Psychiatric Disordersmentioning

confidence: 82%

“…Intercellular processes within the microenvironment that limit the capacity of a given cell (type) to upregulate the mitochondrial melatonergic pathway drive the suppression of intracrine, autocrine and paracrine melatonin that further upregulates oxidative stress in conjunction with decreased PINK1/parkin and mitophagy, thereby increasing MHC-1, NK cell and CD8 + T cell chemoattraction, and 'autoimmune'-linked cell elimination. Clearly, genetic factors may be acting preferentially in a given cell (type) to bias this outcome of intercellular interactions in a given microenvironment, whilst some cells may be made more liable to 'autoimmune'-linked elimination by medications, such as the not-uncommon effects of lithium in the induction of autoimmune thyroiditis and hypothyroidism in bipolar disorder patients [142].…”

Section: Local Intercellular Interactions Mitochondrial Melatonin And...mentioning

confidence: 99%

Redefining Autoimmune Disorders’ Pathoetiology: Implications for Mood and Psychotic Disorders’ Association with Neurodegenerative and Classical Autoimmune Disorders

Anderson¹,

Almulla

Reíter

et al. 2023

Cells

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Although previously restricted to a limited number of medical conditions, there is a growing appreciation that ‘autoimmune’ (or immune-mediated) processes are important aspects of a wide array of diverse medical conditions, including cancers, neurodegenerative diseases and psychiatric disorders. All of these classes of medical conditions are associated with alterations in mitochondrial function across an array of diverse cell types. Accumulating data indicate the presence of the mitochondrial melatonergic pathway in possibly all body cells, with important consequences for pathways crucial in driving CD8+ T cell and B-cell ‘autoimmune’-linked processes. Melatonin suppression coupled with the upregulation of oxidative stress suppress PTEN-induced kinase 1 (PINK1)/parkin-driven mitophagy, raising the levels of the major histocompatibility complex (MHC)-1, which underpins the chemoattraction of CD8+ T cells and the activation of antibody-producing B-cells. Many factors and processes closely associated with autoimmunity, including gut microbiome/permeability, circadian rhythms, aging, the aryl hydrocarbon receptor, brain-derived neurotrophic factor (BDNF) and its receptor tyrosine receptor kinase B (TrkB) all interact with the mitochondrial melatonergic pathway. A number of future research directions and novel treatment implications are indicated for this wide collection of poorly conceptualized and treated medical presentations. It is proposed that the etiology of many ‘autoimmune’/‘immune-mediated’ disorders should be conceptualized as significantly determined by mitochondrial dysregulation, with alterations in the mitochondrial melatonergic pathway being an important aspect of these pathoetiologies.

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“…Although lithium is accepted as one of the most effective pharmaceutical treatments for mental disorders, it can cause various acute and chronic complications ranging from hypercalcemia and hyperparathyroidism to parathyroid adenoma and hyperplasia (2,11). The treatment for these complications varies from lithium discontinuation to surgical intervention depending on the patient's symptoms and calcium level and the severity of the patient's mental illness (5,13,15).…”

Section: Discussionmentioning

confidence: 99%

“…Lithium also mimics a hypercalcemia hypocalciuria syndrome in phenotype patients, reversible by lithium consumption cessation (11).…”

Section: Symptoms Chronic Lithium Therapymentioning

confidence: 99%

An updated mini-review on the impact of lithium therapy on the parathyroid glands function and structure

Yadollahifarsani¹,

Soleimani²

2022

J Parathyr Dis

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Bipolar disorders are among the most significant neuropsychiatric conditions, affecting many people annually worldwide. Despite being accepted as one of the most effective treatments for this illness, lithium, like any other medicine, is associated with a number of adverse effects. Lithium’s adverse effects are divided into acute and chronic categories. The acute effects include renal, thyroid, and parathyroid dysfunction and hypercalcemia, while the chronic effects involve parathyroid hyperplasia and adenoma, among others. This paper will discuss the physiopathology, prevalence, symptoms, diagnosis, and treatment of lithium’s adverse effects.

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What an endocrinologist should know for patients receiving lithium therapy

Cited by 9 publications

References 47 publications

Effectiveness of ultra-long-term lithium treatment: relevant factors and case series

Effectiveness of ultra-long-term lithium treatment: relevant factors and case series

Redefining Autoimmune Disorders’ Pathoetiology: Implications for Mood and Psychotic Disorders’ Association with Neurodegenerative and Classical Autoimmune Disorders

An updated mini-review on the impact of lithium therapy on the parathyroid glands function and structure

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