Why lithium should be used in patients with bipolar disorder? A scoping review and an expert opinion paper

Sampogna, Gaia; Janiri, Delfina; Albert, Umberto; Caraci, Filippo; Martinotti, Giovanni; Serafini, Gianluca; Tortorella, Alfonso; Zuddas, Alessandro; Sani, Gabriele; Fiorillo, Andrea

doi:10.1080/14737175.2022.2161895

Cited by 10 publications

(3 citation statements)

References 156 publications

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“…Since lithium is generally used in psychiatric disorders that require prolonged treatment, the results recorded in this investigation have revealed that if antimanic drugs like Lithium Carbonate are prescribed to maniac patients they develop nephrotoxicity 11,12 . The damaging effect of Lithium on renal weight was evident in the treated group in this study when compared with the untreated group of rodents.…”

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confidence: 92%

Analysis of the Decrement of Renal Weights in Adult Male Rats after Long Term Lithium Carbonate Ingestion

Kohari,

Hussain Rizvi,

Ali

2024

ashkmdc

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Objective: This analysis was aimed at evaluation of the effects of prolonged ingestion of Lithium carbonate on renal weights in rat models. Methods: In our experimental analysis, twenty healthy male rats of age sixty-five days were randomly divided in two groups. Group A (n =10) and Group B (n=10) was given Lithium carbonate. Group A, which was the control group, was further divided into two subgroups according to time duration Group A1 (n=5) and Group A2 (n=5). The control group rodents were fed a lab diet consisting of vegetables, flour pellets and water for a period of 2 and 6 weeks, whereas Group B (n=10) was the Lithium- treated group which also contained five animals in each group. In the treated Group B the animals were divided according to time duration in B1 (2 weeks), Group B2 (6 weeks). Group B rodents along with the lab diet were given Lithium. At the end of the period, animals were sacrificed, and the skin, fascia, and intestines were separated and removed. The red oval kidney was weighed on Digital Weighing Balance at 2 and 6 weeks in all the Groups and recorded. Statistical Analysis was per- formed on SPSS version–16. Results: The renal weights in grams of both groups were documented and it was found that Groups B1 and B2 treated with Lithium carbonate showed statistically highly significantly decreased p-value <0.001 of renal weights as compared to the Control Groups A1 and A2 which were on Lab diet. There were statistically highly significantly decreased renal weights at 6 weeks in group B2 than in Group B1, A1, and A2. Conclusion: This analytical research has proved that renal damage occurs due to decreased renal weights in rat models due to prolonged intake of Lithium carbonate.

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confidence: 92%

Analysis of the Decrement of Renal Weights in Adult Male Rats after Long Term Lithium Carbonate Ingestion

Kohari,

Hussain Rizvi,

Ali

2024

ashkmdc

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“…Several pharmacological treatments are indicated as first-line treatment for the management of patients with bipolar disorder, with lithium being the gold standard due to its established mood-stabilizing properties, its effectiveness in preventing recurrences, and its anti-suicidal effects [20,21]. Since its introduction more than 70 years ago [22], lithium has been successfully used to treat bipolar disorder, and it is now unanimously considered the first line option for acute and long-term treatment [23,24].…”

Section: Introductionmentioning

confidence: 99%

Facts and myths about the use of lithium for bipolar disorder in routine clinical practice: an expert consensus paper

Fiorillo,

Sampogna,

Albert

et al. 2023

Ann Gen Psychiatry

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Background Bipolar disorder is one of the most burdensome severe mental disorders, characterized by high levels of personal and social disability. Patients often need an integrated pharmacological and non-pharmacological approach. Lithium is one of the most effective treatments available not only in psychiatry, but in the whole medicine, and its clinical efficacy is superior to that of other mood stabilizers. However, a declining trend on lithium prescriptions has been observed worldwide in the last 20 years, supporting the notion that lithium is a ‘forgotten drug’ and highlighting that the majority of patients with bipolar disorder are missing out the best available pharmacological option. Based on such premises, a narrative review has been carried out on the most common “misconceptions” and “stereotypes” associated with lithium treatment; we also provide a list of “good reasons” for using lithium in ordinary clinical practice to overcome those false myths. Main text A narrative search of the available literature has been performed entering the following keywords: “bipolar disorder”, “lithium”, “myth”, “mythology”, “pharmacological treatment”, and “misunderstanding”. The most common false myths have been critically revised and the following statements have been proposed: (1) Lithium should represent the first choice for the treatment of patients with bipolar disorder; (2) lithium treatment is effective in different patients’ groups suffering from bipolar disorder; (3) Drug–drug interaction risk can be easily managed during lithium treatment; (4) The optimal management of lithium treatment includes periodical laboratory tests; (5) Slow-release lithium formulation has advantages compared to immediate release formulation; (6) Lithium treatment has antisuicidal properties; (7) Lithium can be carefully managed during pregnancy. Conclusions In recent years, a discrepancy between evidence-based recommendations and clinical practice in using lithium treatment for patients with bipolar disorder has been highlighted. It is time to disseminate clear and unbiased information on the clinical efficacy, effectiveness, tolerability and easiness to use of lithium treatment in patients with bipolar disorder. It is necessary to reinvigorate the clinical and academic discussion about the efficacy of lithium, to counteract the decreasing prescription trend of one of the most effective drugs available in the whole medicine.

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“…Lithium is a rst-line drug and an effective mood stabilizer for bipolar disorder.Until today, lithium salt is still regarded as a classic drug to prevent mania and suicide in bipolar patients [13]. And lithium also have positive e cacy in bipolar depression [14].Many studies have shown that the clinical e cacy of lithium is related to its neuroprotective effect [15], but its mechanism is still unclear.…”

Section: Introductionmentioning

confidence: 99%

Lithium Carbonate Alleviate Neuronal Apoptosis to Improve Depression Symptoms in Mice by the JNK/c-Jun Signaling Pathway

Jin,

Liu

et al. 2023

Preprint

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Why lithium should be used in patients with bipolar disorder? A scoping review and an expert opinion paper

Cited by 10 publications

References 156 publications

Analysis of the Decrement of Renal Weights in Adult Male Rats after Long Term Lithium Carbonate Ingestion

Analysis of the Decrement of Renal Weights in Adult Male Rats after Long Term Lithium Carbonate Ingestion

Facts and myths about the use of lithium for bipolar disorder in routine clinical practice: an expert consensus paper

Lithium Carbonate Alleviate Neuronal Apoptosis to Improve Depression Symptoms in Mice by the JNK/c-Jun Signaling Pathway

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