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Lithium in severe affective disorders: Balancing safety with efficacy

Published online by Cambridge University Press:  13 August 2021

R. Almeida Leite ,
M. Almeida ,
J. Borges  and
A. Costa
R. Almeida Leite
Affiliation:
Psychiatry And Mental Health, Baixo Vouga Hospital Centre, Aveiro, Portugal
M. Almeida*
Affiliation:
Psychiatry And Mental Health, Baixo Vouga Hospital Centre, Aveiro, Portugal
J. Borges
Affiliation:
Psychiatry And Mental Health, Baixo Vouga Hospital Centre, Aveiro, Portugal
A. Costa
Affiliation:
Psychiatry And Mental Health, Baixo Vouga Hospital Centre, Aveiro, Portugal
*
*Corresponding author.

Abstract

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Introduction

Lithium has been one of the oldest substances used in psychiatric treatments and remains the first-line treatment for prevention of manic and depressive episodes of bipolar disorder (BD), but it has also a wide spectrum of side-effects.

Objectives

The goal is to review efficacy, and clinical use of lithium, such as its side effects, and its benefit-to-risk ratio.

Methods

Non-systematic literature review based on scientific databases such as PubMed.

Results

The first modern use of lithium was for the treatment of mania. Lithium has also proven useful in major depression, particularly for augmentation of antidepressants, for aggressive behavior and it has a specific antisuicide effect. Lithium’s prophylactic and antisuicidal effects are most unique. However, the use of lithium became problematic due to the serious toxicity since lithium also a narrow therapeutic index, with therapeutic levels between 0.6 and 1.5 mEq/L.

Conclusions

Awareness of the benefits and risks of lithium is essential for the use of this lifesaving agent. Lithium levels must be carefully monitored and lithium dosage adjusted as necessary.

Disclosure

No significant relationships.

Keywords

lithiumbipolar affective disorderSuicideside effects
Type
Abstract
Information
European Psychiatry , Volume 64 , Special Issue S1: Abstracts of the 29th European Congress of Psychiatry , April 2021 , pp. S778
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association
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