scholarly journals Overview of lithium's use: a nationwide survey

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Xabier Pérez de Mendiola ◽  
Diego Hidalgo-Mazzei ◽  
Eduard Vieta ◽  
Ana González-Pinto
Keyword(s):  
Adverse Effects ◽  
Clinical Guidelines ◽  
Lithium Treatment ◽  
Scientific Evidence ◽  
Plasma Concentrations ◽  
Maintenance Phase ◽  
Nationwide Survey ◽  
Developed Countries ◽  
Lithium Salts ◽  
National Society

Abstract Background Lithium is considered the gold standard treatment for bipolar disorder (BD). Current clinical guidelines and scientific evidence support its use as a first-line treatment in BD. However, over the last two decades, there has been a downward tendency in lithium's use in several developed countries. Based on a nationwide survey, this study's objective is to analyze in a large sample of psychiatrists relevant issues of the use of lithium salts in BD. Methods Data were collected through an anonymous survey sent by email among 500 psychiatrists who belong to a National Society of Psychiatry (Spanish Society of Biological Psychiatry). The survey is a self-administered questionnaire consisting of 21 items on the most key aspects of lithium's use (indication, dosage, monitoring, and information for patients). Results 212 psychiatrists completed the survey. 70% of psychiatrists prescribe lithium to more than 50% of patients diagnosed with BD. Adverse effects are the main reason not to use lithium salts. Over 75% of the participants consider lithium salts the treatment of choice for the maintenance phase of BD, both in women and men. Most of the participants (> 50%) start lithium after the first affective episode, use conservative plasma concentrations (0.6–0.8 mmol/L), and generally prescribe it twice a day. 57% of psychiatrists who treat patients under 18 do not use lithium in this population. About 70% of the survey respondents use official protocols to inform and monitor patients on lithium treatment. Conclusions From the results of the present study, it can be concluded that the use of lithium in Spain is in line with the recommendations of the main international clinical guidelines and current scientific literature. The first reason not to prescribe lithium in our country is the perception of its adverse effects and not the aspects related to its practical use or its effectiveness. Considering that BD is a chronic disease with a typical onset in adolescence, the low rate of prescription of lithium salts in patients under 18 must be thoroughly studied.

scholarly journals Overview of Lithium´s Use: A Nationwide Survey

2020 ◽  
Author(s):  
Xabier Pérez de Mendiola ◽  
Diego Hidalgo-Mazzei ◽  
Eduard Vieta ◽  
Ana González-Pinto
Keyword(s):  
Adverse Effects ◽  
Clinical Guidelines ◽  
Lithium Treatment ◽  
Scientific Evidence ◽  
Plasma Concentrations ◽  
Maintenance Phase ◽  
Nationwide Survey ◽  
Developed Countries ◽  
Lithium Salts ◽  
National Society

Abstract Background: Lithium is considered the gold standard treatment for bipolar disorder (BD). Its use as a first-line treatment in BD is supported by current clinical guidelines and scientific evidence. However, over the last two decades it has been observed a downward tendency in lithium´s use in several developed countries. Based on a nationwide survey, the objective of this study is to analyze in a large sample of psychiatrists relevant issues of the use of lithium salts in BD.Methods: Data were collected through an anonymous survey sent by email among 500 psychiatrists who belong to a National Society of Psychiatry (Spanish Society of Biological Psychiatry). The survey is a self-administered questionnaire consisting of 21 items on the most key aspects of the use of lithium (indication, dosage, monitoring and information for patients).Results: 212 psychiatrists completed the survey. 70% of psychiatrists prescribe lithium to more than 50% of patients diagnosed with BD. Adverse effects are the main reason not to use lithium salts. Over 75% of the participants consider lithium salts the treatment of choice for the maintenance phase of BD, both in women and men. Most of the participants (> 50%) start lithium after the first affective episode, use conservative plasma concentrations (0.6-0.8 mmol/L) and generally prescribe it twice a day. 57% of psychiatrists who treat patients under 18 do not use lithium in this population. About 70% of the survey respondents use official protocols to inform and monitor patients who are on lithium treatment.Conclusions: From the results of the present study it can be concluded that the use of lithium in Spain is in line with the recommendations of the main international clinical guidelines and current scientific literature. The first reason not to prescribe lithium in our country is the perception of its adverse effects and not the aspects related to its practical use or its effectiveness. Considering that BD is a chronic disease that has a typical onset in adolescence, the reasons for the low rate of prescription of lithium salts in patients under 18 must be thoroughly studied.

Where Disagreements Can Lie

2018 ◽  
Author(s):  
Inmaculada de Melo-Martín ◽  
Kristen Intemann
Keyword(s):  
Adverse Effects ◽  
Empirical Evidence ◽  
Significant Role ◽  
Scientific Evidence ◽  
Shared Values ◽  
Policy Decisions

Chapter 10 proposes a second recommendation to deal with the negative adverse effects that normatively inappropriate dissent (NID) can have: it calls for a recognition of the limits of scientific evidence when it comes to public policymaking and for an increased focus on potential differences in the values that underlie policy decisions. It contends that while confusion and doubt about the existing empirical evidence or about its strength can contribute to stalled policies, disagreements about values can also play a significant role. Such disagreements can involve what people take to be valuable, how to interpret shared values, how to weigh conflicting values, and what policies are better for promoting certain valuable goals.

Women's perceptions of the safety of the pill: a survey in eight developing countries

1987 ◽  
Vol 19 (3) ◽  
pp. 313-321 ◽  
Author(s):  
Gary S. Grubb
Keyword(s):  
Developing Countries ◽  
Family Planning ◽  
Adverse Effects ◽  
Birth Defects ◽  
Health Risks ◽  
Scientific Evidence ◽  
Protective Effects ◽  
Gallup Poll ◽  
The Us ◽  
Women’S Perceptions

SummaryIn January 1985, a Gallup poll sponsored by the American College of Obstetrics and Gynecologists reported that 76% of the US women sampled thought that there were substantial risks with using the pill, 31% thought the pill caused cancer and 64% thought the risk of childbearing was equal to or less than that in taking the pill. To assess the perceptions of the pill's safety internationally, a survey of 100–150 urban, middle-class women aged 18–45 years was conducted in each of eight countries in the developing world. There were striking similarities in perceptions of the pill's health effects between countries: (1) taking the pill is considered to have substantial health risks by 50–75% and is thought to be more hazardous than childbearing by over 40% of respondents except those in the African samples; (2) women who had used the pill are as unaware as those who had not of possible serious cardiovascular adverse effects; (3) the protective effects of the pill are virtually unknown; (4) the greatest inconsistency with scientific evidence concerns the risks of sterility and birth defects attributed to pill use. With information from this survey, family planning programmes can rectify almost universal misperceptions of the pill's safety when counselling new and continuing pill users.

scholarly journals Treatment-emergent hypomania possibly associated with over-the-counter supplements

2017 ◽  
Vol 7 (4) ◽  
pp. 160-163
Author(s):  
William Olsufka ◽  
Mary-Ann Abraham
Keyword(s):  
Adverse Effects ◽  
Alternative Medicine ◽  
Complementary And Alternative Medicine ◽  
Safety Profile ◽  
General Public ◽  
Scientific Evidence ◽  
Western World ◽  
Over The Counter ◽  
Treatment Of Depression ◽  
Number Of Patients

Abstract The use of complementary and alternative medicine (CAM) is gaining popularity in the Western world. Among the general public, CAM is often perceived to be associated with less stigma, fewer adverse effects, and may be more affordable. A number of patients utilize CAM for the treatment of depression; however, as there is limited scientific evidence, the safety profile of these supplements are largely unknown. In this case, a 42-year-old man developed hypomania approximately 1 week after S-adenosylmethionine (SAMe) and 5-hydroxytryptophan (5-HTP) therapy was initiated for depression. The combination of SAMe and 5-HTP can potentially induce hypomanic episodes.

scholarly journals ADVERSE EFFECTS OF EXTRADURAL AND INTRATHECAL OPIATES: REPORT OF A NATIONWIDE SURVEY IN SWEDEN

1982 ◽  
Vol 54 (5) ◽  
pp. 479-486 ◽  
Author(s):  
L.L. GUSTAFSSON ◽  
B. SCHILDT ◽  
K. JACOBSEN
Keyword(s):  
Adverse Effects ◽  
Nationwide Survey

Lithium Clinics in Berlin and Dresden: a 50-Year Experience

2018 ◽  
Vol 51 (05) ◽  
pp. 166-171 ◽  
Author(s):  
Werner Felber ◽  
Michael Bauer ◽  
Ute Lewitzka ◽  
Bruno Müller-Oerlinghausen
Keyword(s):  
Side Effects ◽  
Lithium Treatment ◽  
Scientific Evidence ◽  
Bipolar Disorders ◽  
Lithium Therapy ◽  
Psychopharmacological Treatment ◽  
Academic Settings ◽  
History Of ◽  
The 1960S

AbstractAlthough lithium’s serendipitous discovery as a medication for depression dates back more than 200 years, the first scientific evidence that it prevents mania and depression arose only in the 1960s. However, at that time there was a lack of knowledge about how to administer and monitor lithium therapy safely and properly. The lithium clinics in Dresden and Berlin were remarkably similar in their beginnings in the late 1960s regarding patient numbers and scientific expertise without being aware of one another due to the Iron Curtain separating Germany into a western and eastern part until 1990. In what were initially lithium-care programs run independently from one another, the lithium clinics embedded in academic settings in Dresden and Berlin represent a milestone in the history of psychopharmacological treatment of affective disorders in Germany and trailblazers for today’s lithium therapy. Nowadays, lithium’s clinical applications are unquestioned, such as its use in strategies to prevent mood episodes and suicide, and to treat depression. The extensively documented knowledge of lithium treatment is the fruit of more than 50 years of observing disease courses and of studying side effects and influencing factors of lithium prophylaxis. Its safe and proper administration—in determining the correct indication, baseline and follow-up examinations, recommended dosages, monitoring, or the management of side effects—is well established. Subsequently, both national and international guidelines continue recommending lithium as the gold standard in treating patients with unipolar and bipolar disorders.

Science

2019 ◽  
pp. 257-269
Author(s):  
Candy Gunther Brown
Keyword(s):  
Adverse Effects ◽  
Scientific Evidence ◽  
Health Benefits ◽  
Brain Regions ◽  
History Of ◽  
Behavioral Therapies ◽  
Small Sample Sizes ◽  
Citation Bias ◽  
Anxiety Depression ◽  
Meditative Practices

Chapter 12 contextualizes scientific claims about health benefits and considers evidence of adverse effects. The chapter argues that scientific support for school-based yoga, mindfulness, and meditation is weaker than often claimed and falls short of demonstrating that programs are secular, safe, or superior to alternatives. Low-quality studies report health benefits, using uncontrolled, pre-post designs, or nonactive controls, with small sample sizes, and high risk of bias, including expectation bias, researcher allegiance, publication bias, and citation bias; higher quality studies show less efficacy. Scientific evidence is not equivalent to evidence of secularity; research studies report that meditation in religious contexts, as well as prayer and Bible reading, can benefit health and activate specific brain regions. Some participants report challenging experiences with meditative practices, including anxiety, depression, physical pain, reexperiencing of traumatic memories, anger, and suicidality. Meditative practices may be contraindicated for participants with a history of trauma, PTSD, addiction, psychosis, anxiety, depression, or suicidality. Research shows that alternatives, such as aerobic exercise, math, music, nutritious food, or different behavioral therapies, can produce comparable benefits, including training the brain through neuroplasticity. Yet marketers rarely disclose risks of adverse effects, screen for contraindications, or provide information about alternatives.

SPCCTDM, a Catalogue for Analysis of Therapeutic Drug Monitoring Related Contents

2013 ◽  
pp. 319-328
Author(s):  
Sven Ulrich ◽  
Pierre Baumann ◽  
Andreas Conca ◽  
Hans-Joachim Kuss ◽  
Viktoria Stieffenhofer ◽  
...  
Keyword(s):  
Drug Therapy ◽  
Therapeutic Drug Monitoring ◽  
Text Mining ◽  
Drug Monitoring ◽  
Text Analysis ◽  
Scientific Evidence ◽  
Plasma Concentrations ◽  
Therapeutic Drug ◽  
Drug Reactions ◽  
First Time

Therapeutic drug monitoring (TDM) has consistently been shown to be useful for optimization of drug therapy. For the first time, a method has been developed for the text analysis of TDM in SPCs in that a catalogue SPC-ContentTDM (SPCCTDM) provides a codification of the content of TDM in SPCs. It consists of six structure-related items (dose, adverse drug reactions, drug interactions, overdose, pregnancy/breast feeding, and pharmacokinetics) according to implicit or explicit references to TDM in paragraphs of the SPC, and four theory-guided items according to the information about ranges of plasma concentrations and a recommendation of TDM in the SPC. The catalogue is regarded as valid for the text analysis of SPCs with respect to TDM. It can be used in the comparison of SPCs, in the comparison with medico-scientific evidence and for the estimation of the perception of TDM in SPCs by the reader. Regarding the approach as a model of text mining, it may be extended for evaluation of other aspects reported in SPCs.

One Atmosphere

2010 ◽  
Author(s):  
Peter Singer
Keyword(s):  
Climate Change ◽  
Scientific Evidence ◽  
Developed Countries ◽  
Montreal Protocol ◽  
Intergovernmental Panel ◽  
Policy Makers ◽  
Protective Shield ◽  
Third Assessment Report ◽  
The Developed Countries ◽  
Full Force

There can be no clearer illustration of the need for human beings to act globally than the issues raised by the impact of human activity on our atmosphere. That we all share the same planet came to our attention in a particularly pressing way in the 1970s when scientists discovered that the use of chlorofluorocarbons (CFCs) threatens the ozone layer shielding the surface of our planet from the full force of the sun's ultraviolet radiation. Damage to that protective shield would cause cancer rates to rise sharply and could have other effects, for example, on the growth of algae. The threat was especially acute to the world's southernmost cities, since a large hole in the ozone was found to be opening up each year over Antarctica, but in the long term, the entire ozone shield was imperiled. Once the science was accepted, concerted international action followed relatively rapidly with the signing of the Montreal Protocol in 1985. The developed countries phased out virtually all use of CFCs by 1999, and the developing countries, given a 10-year period of grace, are now moving toward the same goal. Getting rid of CFCs has turned out to be just the curtain raiser: the main event is climate change, or global warming. Without belittling the pioneering achievement of those who brought about the Montreal Protocol, the problem was not so difficult, for CFCs can be replaced in all their uses at relatively little cost, and the solution to the problem is simply to stop producing them. Climate change is a very different matter. The scientific evidence that human activities are changing the climate of our planet has been studied by a working group of the Intergovernmental Panel on Climate Change (IPCC), an international scientific body intended to provide policy makers with an authoritative view of climate change and its causes. The group released its Third Assessment Report in 2001, building on earlier reports and incorporating new evidence accumulated over the previous five years. The report is the work of 122 lead authors and 515 contributing authors, and the research on which it was based was reviewed by 337 experts.

scholarly journals The impact of maternal obesity on maternal and fetal outcome

2019 ◽  
Vol 9 (1) ◽  
pp. 104
Author(s):  
Esther Kamalarani A. ◽  
Ramyajothi . ◽  
Ramalakshmi S.
Keyword(s):  
Developing Countries ◽  
Adverse Effects ◽  
Maternal Obesity ◽  
Gestational Hypertension ◽  
Developed Countries ◽  
Fetal Outcome ◽  
Health Concern ◽  
The Past ◽  
Group 2 ◽  
The Impact

Background: Obesity continues to be a global health concern. Although the increasing obesity rates in developed countries has slowed down in the past 10 years, obesity rates in developing countries continue to increase, as much as three times in some developing countries over the past 30 years. The aim of the study was to determine the adverse effects of obesity in pregnancy and maternal and fetal outcome.Methods: In all patients, a detailed history was taken and examinations and investigations were carried out.  Based on BMI (body mass index), patients were divided into 2 groups. Group 1 = patients with BMI >30 kg/m2 and Group 2 = patients with BMI <30 kg /m2.Results: In our study, comparing pregnant mothers with BMI >30 kg/m2 and normal BMI, authors found that the prevalence of maternal and fetal complications was higher in the obese group. Prevalence of antenatal complications like gestational hypertension, preeclampsia, imminent eclampsia and gestational diabetes mellitus requiring control with insulin was higher in obese women.Conclusions: Obesity is associated with increased adverse effects on pregnancy and its outcome.

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