Ultra-long-term lithium therapy: all-important matters and a case of successful 50-year lithium treatment

Abstract

This paper discusses essential issues related to long-term lithium therapy and presents a case of successful 50-year lithium treatment. Lithium is currently regarded as the drug of choice for preventing manic and depressive recurrences in bipolar disorder. In 1/3 of patients with bipolar disorder, long-term monotherapy with lithium can completely prevent recurrences of abnormal mood. Numerous clinical and psychosocial factors associated with a good response to lithium have been described. Lithium is more efficacious than other mood stabilizers, and its long-term treatment significantly exceeds them. Lithium also exerts antisuicidal, immunomodulatory, and neuroprotective effects. The main problems associated with long-term lithium treatment include kidney, thyroid, and probably cognitive issues. In this paper, a case of successful continuous lithium treatment for 50 years in a 79-year-old female patient is presented. In this patient, apart from maintaining a euthymic state, long-term lithium treatment also exerted a favorable effect on general health, especially the elimination of viral and other respiratory infections. It is concluded that ultra-long term lithium therapy can enable good professional and psychosocial functioning for many patients, and the possible somatic side effects are manageable.

Parkinson’s Disease: Potential Actions of Lithium by Targeting the WNT/β-Catenin Pathway, Oxidative Stress, Inflammation and Glutamatergic Pathway

“…Lithium poisoning has a low mortality rate and persistent cerebellar neurological deficits are uncommon in uncomplicated acute poisoning [ 16 ]. Same observations were reported for appropriate lithium doses with rare cardiac manifestations [ 17 ], gastro-intestinal upset [ 18 ] and endocrine manifestations [ 19 ]. Moreover, low doses of lithium are correlated with lower side-effects [ 20 ] and two reviews advocate the use of lithium therapy despite its potential side effects [ 21 , 22 ].…”

Regional lithium prescription rates and recurrence in bipolar disorder

“…Swedish national recommendations derive from international guidelines and holds lithium as the first-line option for long-term treatment (Adler et al 2014 ). Lithium was first shown to be effective in mania in 1949 (Cade 1949 ) and has been known to prevent mood episodes in BD since the 1960s (Baastrup 1964 ; Hartigan 1963 ; Ferensztajn-Rochowiak et al 2020 ). A meta-analysis of randomized controlled trials (RCT) with lithium maintenance treatment (n = 1580, seven trials) demonstrated significant relative risk reductions of 34% for any type of recurrent episodes, 48% for manic episodes, and 22% for depressive episodes (Severus et al 2014 ).…”

To Evaluate the Toxic Effects of Lithium Carbonate on Granule Cells Count of Rat Cerebellum

“…Literature supports Lithium, as thesuccessful drug,for depression 1 .Research conducted by de Cerqueira et al 2,3 (2008) had reported that lithium causes cerebellar degeneration due to significant neuronal loss. At therapeutic doses the most common adverse effects like tremors, incoordination 4 were reported.…”