scholarly journals Lithium in the treatment of bipolar disorder - monitoring of the adverse effects

2020 ◽  
Vol 73 (1-2) ◽  
pp. 49-53
Author(s):  
Milana Okanovic ◽  
Olga Zivanovic ◽  
Mina Cvjetkovic-Bosnjak ◽  
Vladimir Knezevic ◽  
Djendji Siladji ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Side Effects ◽  
Adverse Effects ◽  
Lithium Treatment ◽  
Lithium Therapy ◽  
Parathyroid Function ◽  
First Choice ◽  
Clinically Significant ◽  
American Academy Of Neurology

Introduction. Lithium therapy remains the gold standard in the treatment of bipolar disorder and clinical guidelines recommend it as the first choice for maintenance treatment of bipolar disorder. However, the use of lithium has decreased over the years, mainly due to the fear of its adverse effects. The aim of this paper was to review current literature data for the monitoring and overcoming side effects of lithium therapy in order to provide contemporary evidence for adequate lithium use. Material and Methods. A literature review of lithium therapy in bipolar disorder, using both Medline and manual searches, was performed. Classification of studies, in relation to their quality, was performed using the guidelines established by the American Academy of Neurology. Results. Despite methodological limitations of recent studies, there is irrefutable evidence that lithium therapy can cause toxicity and side effects related to renal, thyroid and parathyroid function, as well as weight gain. Conclusion. There is clear evidence that lithium can cause various side effects, but clinically significant conditions in this regard are rare and successfully treated. Literature data confirm strong efficacy of lithium and suggest its wider use in bipolar disorder. By following clinical recommendations and careful monitoring during lithium treatment, the risk of serious side effects is low compared to its efficacy.

scholarly journals Lithium-Associated Hypercalcemia Presenting with Neuropsychiatric Manifestations in a Patient with Bipolar Disorder

2020 ◽  
Vol 2020 ◽  
pp. 1-2
Author(s):  
Roukaya Benjelloun ◽  
Imane Motaib ◽  
Yassine Otheman
Keyword(s):  
Bipolar Disorder ◽  
Adverse Effects ◽  
Lithium Treatment ◽  
Neuropsychiatric Symptoms ◽  
Parathyroid Function ◽  
Neuropsychiatric Manifestations

One of the overlooked adverse effects of lithium treatment is neuropsychiatric manifestations induced by hypercalcemia (LAH). Here, we present the case of a patient, with bipolar disorder under lithium, who presented with neuropsychiatric symptoms that revealed hyperparathyroidism-induced hypercalcemia. This case illustrates the importance of monitoring parathyroid function and calcium levels in patients under lithium, especially in premenopaused women. LAH may mimic symptoms of manic episodes and should be sought in the case of brutal onset of confusion, anxiety, and/or hallucinations in the course of a bipolar disorder.

scholarly journals Lithium therapy in literature and art

2021 ◽  
Vol 36 (4) ◽  
pp. 271-284
Author(s):  
Janusz Rybakowski
Keyword(s):  
Bipolar Disorder ◽  
Literature Review ◽  
Mood Disorders ◽  
Lithium Treatment ◽  
Lithium Carbonate ◽  
Lithium Therapy ◽  
Therapeutic Action ◽  
Robert Lowell ◽  
Bipolar Mood Disorder ◽  
First Choice

Introduction. In 1949, Australian psychiatrist John Cade described a therapeutic action of lithium carbonate in mania. This date is regarded as an introduction of lithium into contemporary psychiatric therapeutics and the beginning of modern psychopharmacology. In the early 1960s, a prophylactic activity of lithium was observed, preventing recurrences of affective episodes in mood disorders. Lithium has become a prototype of the mood-stabilising drugs and remains a drug of the first choice for the prophylaxis of recurrences in bipolar mood disorder. Literature review. Both the introduction of lithium into psychiatric therapy and its therapeutic action has been reflected in literature and art. This article presents the connections of lithium therapy with literature and art. They pertain to such characters as John Cade, Salvador Luria, Patty Duke, Kay Jamison, Jerzy Broszkiewicz, Ota Pavel, Robert Lowell, Jaime Lowe, Nicole Lyons, Kurt Cobain, Sting, and the band Evanescence. Conclusions. Special attention was given to the book Unquiet mind, written in 1996 by Kay Jamison, professor of psychology. In the book, her personal bipolar disorder and lithium treatment were described from the viewpoint of the eminent professional. Polish translation of the book titled Niespokojny umysł already has two editions: in 2000 and 2018.

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.

Combined clozapine-lithium treatment for schizophrenia and schizoaffective disorder

1998 ◽  
Vol 13 (2) ◽  
pp. 104-106 ◽  
Author(s):  
M Moldavsky ◽  
D Stein ◽  
R Benatov ◽  
P Sirota ◽  
A Elizur ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Schizoaffective Disorder ◽  
Negative Symptoms ◽  
Rating Scale ◽  
Lithium Treatment ◽  
Brief Psychiatric Rating Scale ◽  
Psychiatric Rating ◽  
Clinically Significant ◽  
Psychiatric Rating Scale ◽  
Positive And Negative Symptoms

SummaryThree adolescent and two adult patients suffering from chronic excited psychoses (either schizophrenia or schizoaffective disorder) resistant to traditional neuroleptics and clozapine were treated with combined clozapine-lithium. Improvement was assessed with the Positive and Negative Symptoms Scale, the Brief Psychiatric Rating Scale and the Clinical Global Impressions, administered before and during combined clozapine-lithium treatment. All patients demonstrated a significant improvement with this combination. There was no occurrence of agranulocytosis, neuroleptic malignant syndrome or other clinically significant adverse effects.

Recommendations for Monitoring Lithium Therapy

1983 ◽  
Vol 17 (5) ◽  
pp. 346-350 ◽  
Author(s):  
Ronald B. Salem
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Serum Levels ◽  
Normal Serum ◽  
Lithium Therapy ◽  
Organ Systems

The literature concerning side effects of normal serum levels of lithium on various organ systems is reviewed. Suggestions for monitoring and managing these adverse effects are discussed. A table is presented that provides recommendations for evaluation prior to initiation and during follow-up of therapy.

scholarly journals Emerging Use of Epidiolex (Cannabidiol) in Epilepsy

2020 ◽  
Vol 25 (6) ◽  
pp. 485-499 ◽  
Author(s):  
Renad Abu-Sawwa ◽  
Brielle Scutt ◽  
Yong Park
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Drug Interactions ◽  
The United States ◽  
Dravet Syndrome ◽  
Future Research ◽  
Epileptic Syndromes ◽  
History Of ◽  
Clinically Significant ◽  
Antiepileptic Medications

The first plant-derived, purified pharmaceutical-grade cannabidiol (CBD) medication, Epidiolex, was approved in the United States by the FDA on June 25, 2018. Its approval for patients ≥ 2 years of age with Dravet syndrome (DS) or Lennox-Gastaut syndrome (LGS) markedly altered the treatment of medically refractory seizures in these disorders. This state-of-the-art review will discuss the history of CBD, its current pharmacology and toxicology, evidence supporting its use in a variety of epileptic syndromes, common side effects and adverse effects, and pharmacokinetically based drug-drug interactions. Owing to the importance in considering side effects, adverse effects, and drug-drug interactions in patients with medically refractory epilepsy syndromes, this review will take a deeper look into the nuances of the above within a clinical context, as compared to the other antiepileptic medications. Furthermore, despite the limited data regarding clinically significant drug-drug interactions, potential pharmacokinetic drug-drug interactions with CBD and other antiepileptics are theorized on the basis of their metabolic pathways. The article will further elucidate future research in terms of long-term efficacy, safety, and drug interactions that is critical to addressing unanswered questions relevant to clinical practice.

scholarly journals Lithium in mood disorders: increasing evidence base, declining use?

2007 ◽  
Vol 191 (6) ◽  
pp. 474-476 ◽  
Author(s):  
Allan H. Young ◽  
Judith M Hammond
Keyword(s):  
Bipolar Disorder ◽  
Side Effects ◽  
Mood Disorders ◽  
Lithium Treatment ◽  
Evidence Base ◽  
Efficacious Treatment ◽  
Meta Analyses

SummaryUse of lithium for the treatment of bipolar disorder may be declining even as knowledge of the efficacy and side-effects of lithium has increased. Recent meta-analyses confirm the benefits of maintenance lithium treatment and show that it reduces suicide and suicidality. Psychiatrists should continue to utilise this efficacious treatment for bipolar disorder.

Case study: Bipolar disease in treatment with asenapine

2016 ◽  
Vol 33 (S1) ◽  
pp. S328-S329 ◽  
Author(s):  
A.M. Alvarez Montoya ◽  
C. Diago Labrador ◽  
T. Ruano Hernandez
Keyword(s):  
Bipolar Disorder ◽  
Adverse Effects ◽  
Lithium Treatment ◽  
Type I ◽  
Toxic Substances ◽  
Benign Intracranial Hypertension ◽  
Adherence To Treatment ◽  
Competing Interest ◽  
Treatment Alternatives ◽  
Disorder Type

ObjectivesAnalysis of the treatment alternatives for patients diagnosed with a bipolar disorder of torpid evolution. Revision of the possible adverse effects of lithium and its impact on the adherence to treatment.MethodsWe revise the clinical evolution of a patient diagnosed with Bipolar disorder type I, with the following characteristics: at least two maniac episodes per year, consumption of toxic substances and high sensibility to antipsychotics and euthymics.ResultsWe will describe the case of a 23-years-old patient diagnosed with bipolar disorder type I. During the course of the illness, benign intracranial hypertension is diagnosed and the treatment with lithium must be stopped. We replace lithium treatment by Asenapine monotherapy. The evolution of the patient was very positive. Taking account of the adverse effects of lithium and reducing them can facilitate the adherence to treatment and also benefit early remission and less deterioration in each episode.ConclusionsIt is fundamental to promote a comprehensive approach to each patient, including psychotherapy, psychoeducation as well as appropriate medication. The knowledge of the described effects helps us to determinate the appropriate medication for each patient.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The Evolution of Lithium Therapy

1992 ◽  
Vol 6 (2_suppl) ◽  
pp. 325-329 ◽  
Author(s):  
F. Neil Johnson
Keyword(s):  
Side Effects ◽  
Antidepressant Treatment ◽  
Lithium Treatment ◽  
Serum Levels ◽  
Clinical Applications ◽  
Lithium Therapy ◽  
Antidepressant Effect ◽  
Safe Medication ◽  
Recommended Treatment ◽  
Short Time

The evolution of lithium therapy for the treatment of mania and depression, from its discovery to the present day, is described. Early problems with toxicity have been overcome and lithium is now established as a safe medication, provided serum levels are monitored. The mechanism of action of lithium is not yet known, but biochemical models are beginning to be put forward. Lower doses of lithium than were previously used are now recommended. Treatment with intermittent doses of lithium (every second day) seems to reduce side effects, while maintaining clinical efficacy. Lithium has recently been used in combination with other medications. Augmentation of unsuccessful antidepressant treatment with lithium may produce an antidepressant effect within a short time. Withdrawal from lithium therapy usually results in a relapse. Lithium treatment is also used outside psychiatry. Other potential clinical applications for lithium therapy are discussed.

Lithium and carbamazepine in bipolar disorder

2000 ◽  
Vol 12 (3) ◽  
pp. 120-121 ◽  
Author(s):  
P. Moleman ◽  
E.G.Th.M. Hartong ◽  
C.A.L. Hoogduin ◽  
T.G. Broekman ◽  
W.A. Nolen ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Clinical Trials ◽  
Clinical Practice ◽  
Side Effects ◽  
Alternative Treatments ◽  
First Choice

AbstractLithium is considered first choice in the prevention of prospective episodes in patients with bipolar disorder. However, efficacy is not satisfactory in all patients and side effects sometimes prevent the use of lithium. It is argued that efficacy in clinical practice may be less impressive than anticipated from clinical trials, and alternative treatments are beinu advocated increasingly for that reason, such as the anticonvulsants, carbamazepine and valproate.

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