Clinical use of lithium salts: guide for users and prescribers

Leonardo Tondo^{1

2

3}, Martin Alda⁴, Michael Bauer⁵, Veerle Bergink^{6

7}, Paul Grof⁸, Tomas Hajek⁴, Ute Lewitka⁵, Rasmus W Licht^{9

10}, Mirko Manchia^{11

12}, Bruno Müller-Oerlinghausen¹³, René E Nielsen^{9

10}, Marylou Selo¹⁴, Christian Simhandl¹⁵, Ross J Baldessarini^{16

17}; International Group for Studies of Lithium (IGSLi)

Affiliations

¹ International Consortium for Research on Mood & Psychotic Disorders, McLean Hospital, Belmont, MA, USA. ltondo@aol.com.
² Department of Psychiatry, Harvard Medical School, Boston, MA, USA. ltondo@aol.com.
³ Lucio Bini Mood Disorders Centers, Lucio Bini Center, Via Cavalcanti 28, 09128, Cagliari and Rome, Italy. ltondo@aol.com.
⁴ Department of Psychiatry, Dalhousie University, Halifax, NS, Canada.
⁵ Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital Dresden, Dresden, Germany.
⁶ Department of Psychiatry and Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, USA.
⁷ Department of Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands.
⁸ Mood Disorders Center of Ottawa and Department of Psychiatry, University of Toronto, Toronto, Canada.
⁹ Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
¹⁰ Aalborg University Hospital-Psychiatry, Aalborg, Denmark.
¹¹ Department of Pharmacology, Dalhousie University, Halifax, NS, Canada.
¹² Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
¹³ Drug Commission of the German Medical Association, Berlin, Germany.
¹⁴ International Advocacy, New York, USA.
¹⁵ Medical Faculty, Bipolar Center, Sigmund Freud Private University, Wiener Neustadt, Austria.
¹⁶ International Consortium for Research on Mood & Psychotic Disorders, McLean Hospital, Belmont, MA, USA.
¹⁷ Department of Psychiatry, Harvard Medical School, Boston, MA, USA.

PMID: 31328245
PMCID: PMC6643006
DOI: 10.1186/s40345-019-0151-2

Review

Clinical use of lithium salts: guide for users and prescribers

Leonardo Tondo et al. Int J Bipolar Disord. 2019.

. 2019 Jul 22;7(1):16.

doi: 10.1186/s40345-019-0151-2.

Authors

Affiliations

¹ International Consortium for Research on Mood & Psychotic Disorders, McLean Hospital, Belmont, MA, USA. ltondo@aol.com.
² Department of Psychiatry, Harvard Medical School, Boston, MA, USA. ltondo@aol.com.
³ Lucio Bini Mood Disorders Centers, Lucio Bini Center, Via Cavalcanti 28, 09128, Cagliari and Rome, Italy. ltondo@aol.com.
⁴ Department of Psychiatry, Dalhousie University, Halifax, NS, Canada.
⁵ Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital Dresden, Dresden, Germany.
⁶ Department of Psychiatry and Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, USA.
⁷ Department of Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands.
⁸ Mood Disorders Center of Ottawa and Department of Psychiatry, University of Toronto, Toronto, Canada.
⁹ Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
¹⁰ Aalborg University Hospital-Psychiatry, Aalborg, Denmark.
¹¹ Department of Pharmacology, Dalhousie University, Halifax, NS, Canada.
¹² Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
¹³ Drug Commission of the German Medical Association, Berlin, Germany.
¹⁴ International Advocacy, New York, USA.
¹⁵ Medical Faculty, Bipolar Center, Sigmund Freud Private University, Wiener Neustadt, Austria.
¹⁶ International Consortium for Research on Mood & Psychotic Disorders, McLean Hospital, Belmont, MA, USA.
¹⁷ Department of Psychiatry, Harvard Medical School, Boston, MA, USA.

PMID: 31328245
PMCID: PMC6643006
DOI: 10.1186/s40345-019-0151-2

Abstract

Background: Lithium has been used clinically for 70 years, mainly to treat bipolar disorder. Competing treatments and exaggerated impressions about complexity and risks of lithium treatment have led to its declining use in some countries, encouraging this update about its safe clinical use. We conducted a nonsystematic review of recent research reports and developed consensus among international experts on the use of lithium to treat major mood disorders, aiming for a simple but authoritative guide for patients and prescribers.

Main text: We summarized recommendations concerning safe clinical use of lithium salts to treat major mood disorders, including indications, dosing, clinical monitoring, adverse effects and use in specific circumstances including during pregnancy and for the elderly.

Conclusions: Lithium continues as the standard and most extensively evaluated treatment for bipolar disorder, especially for long-term prophylaxis.

Keywords: Bipolar disorder; Blood testing; Dosing; Lithium; Side-effects.

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Conflict of interest statement

Supported by grants from the Bruce J Anderson Foundation and the McLean Private Donors Psychiatric Research Fund (to RJB). VB has received grants by the Blavatnik Women’s Health institute. RWL has received research grants from Glaxo Smith Kline, honoraria for lecturing from Pfizer, Glaxo Smith Kline, Eli Lilly, Astra-Zeneca, Bristol-Myers Squibb, Janssen Cilag, Lundbeck, Otsuka, Servier and honoraria from advisory board activity from Glaxo Smith Kline, Eli Lilly, Astra-Zeneca, Bristol-Myers Squibb, Janssen Cilag and Sunovion. LT has received honoraria from advisory board for Angelini. No other authors or immediate family members have financial relationships with commercial entities that might appear to represent potential conflicts of interest with the information presented. The remaining authors declare that they have no competing interests.

References

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Clinical use of lithium salts: guide for users and prescribers

Affiliations

Clinical use of lithium salts: guide for users and prescribers

Authors

Affiliations

Abstract

Conflict of interest statement

References

Publication types

Grants and funding

LinkOut - more resources

Full Text Sources