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Current Neuropharmacology 2023Lithium is most well-known for its mood-stabilizing effects in the treatment of bipolar disorder. Due to its narrow therapeutic window (0.5-1.2 mM serum concentration),... (Review)
Review
Lithium is most well-known for its mood-stabilizing effects in the treatment of bipolar disorder. Due to its narrow therapeutic window (0.5-1.2 mM serum concentration), there is a stigma associated with lithium treatment and the adverse effects that can occur at therapeutic doses. However, several studies have indicated that doses of lithium under the predetermined therapeutic dose used in bipolar disorder treatment may have beneficial effects not only in the brain but across the body. Currently, literature shows that low-dose lithium (≤0.5 mM) may be beneficial for cardiovascular, musculoskeletal, metabolic, and cognitive function, as well as inflammatory and antioxidant processes of the aging body. There is also some evidence of low-dose lithium exerting a similar and sometimes synergistic effect on these systems. This review summarizes these findings with a focus on low-dose lithium's potential benefits on the aging process and age-related diseases of these systems, such as cardiovascular disease, osteoporosis, sarcopenia, obesity and type 2 diabetes, Alzheimer's disease, and the chronic low-grade inflammatory state known as inflammaging. Although lithium's actions have been widely studied in the brain, the study of the potential benefits of lithium, particularly at a low dose, is still relatively novel. Therefore, this review aims to provide possible mechanistic insights for future research in this field.
Topics: Humans; Lithium; Diabetes Mellitus, Type 2; Bipolar Disorder; Brain; Dietary Supplements
PubMed: 35236261
DOI: 10.2174/1570159X20666220302151224 -
International Journal of Molecular... Jul 2018In this paper, the authors review the history of the pharmacological treatment of bipolar disorder, from the first nonspecific sedative agents introduced in the 19th and... (Review)
Review
In this paper, the authors review the history of the pharmacological treatment of bipolar disorder, from the first nonspecific sedative agents introduced in the 19th and early 20th century, such as solanaceae alkaloids, bromides and barbiturates, to John Cade's experiments with lithium and the beginning of the so-called "Psychopharmacological Revolution" in the 1950s. We also describe the clinical studies and development processes, enabling the therapeutic introduction of pharmacological agents currently available for the treatment of bipolar disorder in its different phases and manifestations. Those drugs include lithium salts, valproic acid, carbamazepine, new antiepileptic drugs, basically lamotrigine and atypical antipsychotic agents (olanzapine, risperidone, quetiapine, ziprasidone, aripiprazole, asenapine, cariprazine and lurasidone). Finally, the socio-sanitary implications derived from the clinical introduction of these drugs are also discussed.
Topics: Animals; Bipolar Disorder; History, 19th Century; History, 20th Century; History, 21st Century; Humans; Lithium; Psychopharmacology; Tranquilizing Agents
PubMed: 30041458
DOI: 10.3390/ijms19072143 -
Journal of Psychopharmacology (Oxford,... Oct 2023Postpartum psychosis (PPP) is a psychiatric emergency that generally warrants acute inpatient care. PPP is marked by the sudden onset of affective and psychotic symptoms... (Review)
Review
BACKGROUND
Postpartum psychosis (PPP) is a psychiatric emergency that generally warrants acute inpatient care. PPP is marked by the sudden onset of affective and psychotic symptoms with a rapid deterioration in mental state. Evidence suggests that PPP is a discrete disorder on the bipolar disorder spectrum with a distinct treatment profile and prognosis.
METHODS
We conducted a PubMed database search for various terms involving PPP and its treatment and included peer-reviewed articles published in English.
OBJECTIVE
To provide a treatment algorithm for the management of PPP based on available evidence.
RESULTS
Pharmacological therapy is the mainstay of PPP management in the acute phase. Evidence points to a combination of antipsychotics and lithium in the acute treatment of PPP. Electroconvulsive therapy can offer a rapid treatment response where required. Lithium appears to have the best evidence for relapse prevention and prophylaxis in PPP. Psychoeducation is essential and psychosocial interventions used in bipolar disorder may be effective in PPP.
CONCLUSION
Early detection and prompt treatment with antipsychotics and lithium, followed by maintenance treatment with lithium, is associated with a favourable prognosis in PPP.
Topics: Female; Humans; Lithium; Psychotic Disorders; Bipolar Disorder; Antipsychotic Agents; Postpartum Period; Algorithms
PubMed: 37515460
DOI: 10.1177/02698811231181573 -
International Journal of Molecular... Dec 2017Lithium has been used for the treatment of bipolar disorder (BD) for the last sixty or more years, and recent studies with more reliable designs and updated guidelines... (Review)
Review
Lithium has been used for the treatment of bipolar disorder (BD) for the last sixty or more years, and recent studies with more reliable designs and updated guidelines have recommended lithium to be the treatment of choice for acute manic, mixed and depressive episodes of BD, along with long-term prophylaxis. Lithium's specific mechanism of action in mood regulation is progressively being clarified, such as the direct inhibition on glycogen synthase kinase 3β, and its various effects on neurotrophic factors, neurotransmitters, oxidative metabolism, apoptosis, second messenger systems, and biological systems are also being revealed. Furthermore, lithium has been proposed to exert its treatment effects through mechanisms associated with neuronal plasticity. In this review, we have overviewed the clinical aspects of lithium use for BD, and have focused on the neuroprotective and neurotrophic effects of lithium.
Topics: Bipolar Disorder; Glycogen Synthase Kinase 3 beta; Humans; Lithium; Nerve Growth Factors; Neuronal Plasticity; Neuroprotection
PubMed: 29232923
DOI: 10.3390/ijms18122679 -
JAMA Psychiatry Jan 2022Suicide and suicide attempts are persistent and increasing public health problems. Observational studies and meta-analyses of randomized clinical trials have suggested... (Randomized Controlled Trial)
Randomized Controlled Trial
IMPORTANCE
Suicide and suicide attempts are persistent and increasing public health problems. Observational studies and meta-analyses of randomized clinical trials have suggested that lithium may prevent suicide in patients with bipolar disorder or depression.
OBJECTIVE
To assess whether lithium augmentation of usual care reduces the rate of repeated episodes of suicide-related events (repeated suicide attempts, interrupted attempts, hospitalizations to prevent suicide, and deaths from suicide) in participants with bipolar disorder or depression who have survived a recent event.
DESIGN, SETTING, AND PARTICIPANTS
This double-blind, placebo-controlled randomized clinical trial assessed lithium vs placebo augmentation of usual care in veterans with bipolar disorder or depression who had survived a recent suicide-related event. Veterans at 29 VA medical centers who had an episode of suicidal behavior or an inpatient admission to prevent suicide within 6 months were screened between July 1, 2015, and March 31, 2019.
INTERVENTIONS
Participants were randomized to receive extended-release lithium carbonate beginning at 600 mg/d or placebo.
MAIN OUTCOMES AND MEASURES
Time to the first repeated suicide-related event, including suicide attempts, interrupted attempts, hospitalizations specifically to prevent suicide, and deaths from suicide.
RESULTS
The trial was stopped for futility after 519 veterans (mean [SD] age, 42.8 [12.4] years; 437 [84.2%] male) were randomized: 255 to lithium and 264 to placebo. Mean lithium concentrations at 3 months were 0.54 mEq/L for patients with bipolar disorder and 0.46 mEq/L for patients with major depressive disorder. No overall difference in repeated suicide-related events between treatments was found (hazard ratio, 1.10; 95% CI, 0.77-1.55). No unanticipated safety concerns were observed. A total of 127 participants (24.5%) had suicide-related outcomes: 65 in the lithium group and 62 in the placebo group. One death occurred in the lithium group and 3 in the placebo group.
CONCLUSIONS AND RELEVANCE
In this randomized clinical trial, the addition of lithium to usual Veterans Affairs mental health care did not reduce the incidence of suicide-related events in veterans with major depression or bipolar disorders who experienced a recent suicide event. Therefore, simply adding lithium to existing medication regimens is unlikely to be effective for preventing a broad range of suicide-related events in patients who are actively being treated for mood disorders and substantial comorbidities.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT01928446.
Topics: Adult; Antimanic Agents; Antipsychotic Agents; Bipolar Disorder; Depressive Disorder, Major; Double-Blind Method; Female; Humans; Lithium; Male; Middle Aged; Outcome Assessment, Health Care; Suicidal Ideation; Suicide, Attempted; Veterans
PubMed: 34787653
DOI: 10.1001/jamapsychiatry.2021.3170 -
Brain and Behavior Aug 2021Bipolar disorder (BD) poses a significant public health concern, with roughly one-quarter of sufferers attempting suicide. BD is characterized by manic and depressive... (Review)
Review
Bipolar disorder (BD) poses a significant public health concern, with roughly one-quarter of sufferers attempting suicide. BD is characterized by manic and depressive mood cycles, the recurrence of which can be effectively curtailed through lithium therapy. Unfortunately, the most frequently employed lithium salt, lithium carbonate (Li CO ), is associated with a host of adverse health outcomes following chronic use: these unwanted effects range from relatively minor inconveniences (e.g., polydipsia and polyuria) to potentially major complications (e.g., hypothyroidism and/or renal impairment). As these undesirable effects can limit patient compliance, an alternative lithium compound with a lesser toxicity profile would dramatically improve treatment efficacy and outcomes. Lithium orotate (LiC H N O ; henceforth referred to as LiOr), a compound largely abandoned since the late 1970s, may represent such an alternative. LiOr is proposed to cross the blood-brain barrier and enter cells more readily than Li CO , which will theoretically allow for reduced dosage requirements and ameliorated toxicity concerns. This review addresses the controversial history of LiOr, complete with discussions of experimental and clinical efficacy, putative mechanisms of action, adverse effects, and its potential future in therapy.
Topics: Antimanic Agents; Bipolar Disorder; Humans; Lithium; Lithium Compounds; Organometallic Compounds
PubMed: 34196467
DOI: 10.1002/brb3.2262 -
Brazilian Dental Journal 2022The aim of this study was conducted to assess the fracture resistance of zirconia reinforced lithium silicate all ceramic material "Celtra Press" compared to lithium...
The aim of this study was conducted to assess the fracture resistance of zirconia reinforced lithium silicate all ceramic material "Celtra Press" compared to lithium disilicate one "IPS e-max Press" under simulated oral conditions. Fourteen ceramic crowns were fabricated on epoxy dies which were duplicated from stainless steel master die and divided into two equal groups (n=7) according to the material of construction; Group A: Crowns fabricated with IPS e-max Press material and Group B: Crowns fabricated with Celtra Press material. The crowns were then cemented onto their corresponding dies with a self-adhesive resin cement and subjected to thermocycling and cyclic loading. Then they were loaded to fractur in a universal testing machine. The results were tabulated and statistically analyzed using Kolmogorov-Smirnov and Shapiro-Wilk tests. Student t-test used to compare mean values. The significance level was set at P ≤ 0.05 and 95% Confidence interval. Statistical analysis was performed using Graph Pad Instat (Graph Pad, Inc.) software for windows. The mean ± SD values of fracture resistance were recorded for lithium Disilicate group (1706.01 ±154.32 N) meanwhile the mean ± SD value recorded with celtra group were (1550.67±196.71 N). Zirconia reinforced lithium silicate ceramic crowns produced comparable fracture resistance values to lithium disilicate ceramic crowns and both tested materials are within the clinically acceptable values in the posterior area.
Topics: Humans; Lithium
PubMed: 36477957
DOI: 10.1590/0103-6440202204993 -
Current Neuropharmacology 2022Lithium is a well-known FDA-approved treatment for bipolar and mood disorders. Lithium has been an enigmatic drug with multifaceted actions involving various... (Review)
Review
Lithium is a well-known FDA-approved treatment for bipolar and mood disorders. Lithium has been an enigmatic drug with multifaceted actions involving various neurotransmitters and intricate cell signalling cascades. Recent studies highlight the neuroprotective and neurotrophic actions of lithium in amyotrophic lateral sclerosis, Alzheimer's disease, intracerebral hemorrhage, and epilepsy. Of note, lithium holds a significant interest in epilepsy, where the past reports expose its non-specific proconvulsant action, followed lately by numerous studies for anti-convulsant action. However, the exact mechanism of action of lithium for any of its effects is still largely unknown. The present review integrates findings from several reports and provides detailed possible mechanisms of how a single molecule exhibits marked pro-epileptogenic as well as anti-convulsant action. This review also provides clarity regarding the safety of lithium therapy in epileptic patients.
Topics: Epilepsy; Humans; Lithium; Lithium Compounds; Mood Disorders; Neuroprotection
PubMed: 35410603
DOI: 10.2174/1570159X20666220411081728 -
Current Neuropharmacology 2023
Topics: Humans; Valproic Acid; Bipolar Disorder; Lithium; Antimanic Agents; Lithium Compounds
PubMed: 37203193
DOI: 10.2174/1570159X2104230307123319 -
Nature Communications Jun 2021From smartphones to electric vehicles, Li-ion batteries have revolutionized our daily lives. Here, we discuss the most important aspects that have enabled lithium-ion...
From smartphones to electric vehicles, Li-ion batteries have revolutionized our daily lives. Here, we discuss the most important aspects that have enabled lithium-ion batteries to thrive, and introduce some of our articles that contribute to the evolution of these devices.
Topics: Cell Phone; Electric Power Supplies; Electrodes; Humans; Lithium; Motor Vehicles; Publications
PubMed: 34193866
DOI: 10.1038/s41467-021-24410-3