Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Dec;5(1):19.
doi: 10.1186/s40345-017-0089-1. Epub 2017 Jul 9.

An observational study of 110 elderly lithium-treated patients followed up for 6 years with particular reference to renal function

Alberto Bocchetta  1   2 , Francesca Cabras  2 , Martina Pinna  2 , Antonio Poddighe  3 , Claudia Sardu  4 , Raffaella Ardau  1 , Caterina Chillotti  1 , Maria Del Zompo  5   6
Affiliations

An observational study of 110 elderly lithium-treated patients followed up for 6 years with particular reference to renal function

Alberto Bocchetta et al. Int J Bipolar Disord. 2017 Dec.

Abstract

Background: Recent observational studies have focused on lithium treatment in the elderly, with particular reference to safety in terms of thyroid and renal functions. The purpose of this study was to compare the clinical characteristics of patients starting lithium treatment before (N = 79) or after (N = 31) the age of 65 years. Patients were followed up for 6 years with focus on renal function and prescription of levothyroxine and methimazole.

Results: At baseline, median lithium serum concentration was 0.55 mmol/l. The estimated glomerular filtration rate was lower than 60 ml/min/1.73 m2 in 43 (39%) patients. In a multiple regression analysis controlling for age and gender, we found a significant effect of duration of lithium treatment on estimated glomerular filtration rate (-0.85 ml/min/1.73 m2 per year of prior exposure). The annual decline during follow-up was 2.3 ml/min/1.73 m2. Two patients were prescribed levothyroxine, and two were prescribed methimazole for the first time during follow-up.

Conclusions: Median lithium serum concentration in this cohort of elderly patients with mainly bipolar disorders was lower than the therapeutic range indicated for younger adults. The decline in glomerular filtration rate may be accelerated by long-term lithium use. Thyroid and renal functions continue to require close monitoring throughout the course of lithium treatment. Trial registration NP/2013/3836. Registered 24 June 2013.

Keywords: Bipolar disorders; Creatinine; Depression; Elderly; Kidney; Lithium; Mood disorders; Nephrotoxicity; Thyroid.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Attrition rate of patients during 6-year follow-up. Number of patients studied, deceased, or otherwise lost to follow-up over the 6 years of the study
See this image and copyright information in PMC

References

    1. Aprahamian I, Santos FS, dos Santos B, Talib L, Diniz BS, Radanovic M, Gattaz WF, Forlenza OV. Long-term, low-dose lithium treatment does not impair renal function in the elderly: a 2-year randomized, placebo-controlled trial followed by single-blind extension. J Clin Psychiatry. 2014;75:e672–e678. doi: 10.4088/JCP.13m08741. - DOI - PubMed
    1. Aziz R, Lorberg B, Tampi RR. Treatment for late-life bipolar disorder. Am J Geriatr Pharmacoterapy. 2006;4:347–364. doi: 10.1016/j.amjopharm.2006.12.007. - DOI - PubMed
    1. Baldessarini RJ, Tarazi FI. Pharmacotherapy of psychosis and mania. In: Brunton LL, Lazo JS, Parker KL, editors. Goodman and Gilman’s the pharmacological basis of therapeutics. 11. New York: McGraw-Hill; 2006. pp. 461–500.
    1. Bauer M, Alda M, Priller J, Young LT, International Group For The Study Of Lithium Treated Patients (IGSLI) Implications of the neuroprotective effects of lithium for the treatment of bipolar and neurodegenerative disorders. Pharmacopsychiatry. 2003;36(Suppl 3):S250–S254. - PubMed
    1. Bauer M, Gitlin M. The essential guide to lithium treatment. Berlin: Springer; 2016.

LinkOut - more resources