Lithium in the treatment of acute bipolar depression: A systematic review and meta-analysis

Rakofsky, Jeffrey J.; Lucido, Michael J.; Dunlop, Boadie W.

doi:10.1016/j.jad.2022.04.058

Cited by 16 publications

(11 citation statements)

References 54 publications

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“…Selenium supplementation in rodents is beneficial for treating depression. The salt form of selenium, sodium selenite, had antidepressant effects in rodents [ 142 ]. Sodium selenite can increase the antidepressant effect of imipramine, fluoxetine, and tianeptine and reduce immobility time on the forced swim test (FST) after the administration of antidepressants [ 143 ].…”

Section: Appropriate Supplementation Of Some Mineral Elements or As M...mentioning

confidence: 99%

Appropriate Macronutrients or Mineral Elements Are Beneficial to Improve Depression and Reduce the Risk of Depression

Zhengyang

Quan

et al. 2023

IJMS

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Depression is a common mental disorder that seriously affects the quality of life and leads to an increasing global suicide rate. Macro, micro, and trace elements are the main components that maintain normal physiological functions of the brain. Depression is manifested in abnormal brain functions, which are considered to be tightly related to the imbalance of elements. Elements associated with depression include glucose, fatty acids, amino acids, and mineral elements such as lithium, zinc, magnesium, copper, iron, and selenium. To explore the relationship between these elements and depression, the main literature in the last decade was mainly searched and summarized on PubMed, Google Scholar, Scopus, Web of Science, and other electronic databases with the keywords “depression, sugar, fat, protein, lithium, zinc, magnesium, copper, iron, and selenium”. These elements aggravate or alleviate depression by regulating a series of physiological processes, including the transmission of neural signals, inflammation, oxidative stress, neurogenesis, and synaptic plasticity, which thus affect the expression or activity of physiological components such as neurotransmitters, neurotrophic factors, receptors, cytokines, and ion-binding proteins in the body. For example, excessive fat intake can lead to depression, with possible mechanisms including inflammation, increased oxidative stress, reduced synaptic plasticity, and decreased expression of 5-Hydroxytryptamine (5-HT), Brain Derived Neurotrophic Factor (BDNF), Postsynaptic density protein 95(PSD-95), etc. Supplementing mineral elements, such as selenium, zinc, magnesium, or lithium as a psychotropic medication is mostly used as an auxiliary method to improve depression with other antidepressants. In general, appropriate nutritional elements are essential to treat depression and prevent the risk of depression.

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Section: Appropriate Supplementation Of Some Mineral Elements or As M...mentioning

confidence: 99%

Appropriate Macronutrients or Mineral Elements Are Beneficial to Improve Depression and Reduce the Risk of Depression

Zhengyang

Quan

et al. 2023

IJMS

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“…Lithium is a metal with a long-lasting history of use as first-line drug for treating bipolar disorder, as well as recurrent depression [ 86 ]. Lithium-induced pharmacological effects were explained by replenishment with BDNF and NGF in patients with depression.…”

Section: Current Insight Into the Potential Of Regenerative Medicine ...mentioning

confidence: 99%

The Role of Metals in the Neuroregenerative Action of BDNF, GDNF, NGF and Other Neurotrophic Factors

et al. 2022

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Mature neurotrophic factors and their propeptides play key roles ranging from the regulation of neuronal growth and differentiation to prominent participation in neuronal survival and recovery after injury. Their signaling pathways sculpture neuronal circuits during brain development and regulate adaptive neuroplasticity. In addition, neurotrophic factors provide trophic support for damaged neurons, giving them a greater capacity to survive and maintain their potential to regenerate their axons. Therefore, the modulation of these factors can be a valuable target for treating or preventing neurologic disorders and age-dependent cognitive decline. Neuroregenerative medicine can take great advantage by the deepening of our knowledge on the molecular mechanisms underlying the properties of neurotrophic factors. It is indeed an intriguing topic that a significant interplay between neurotrophic factors and various metals can modulate the outcome of neuronal recovery. This review is particularly focused on the roles of GDNF, BDNF and NGF in motoneuron survival and recovery from injuries and evaluates the therapeutic potential of various neurotrophic factors in neuronal regeneration. The key role of metal homeostasis/dyshomeostasis and metal interaction with neurotrophic factors on neuronal pathophysiology is also highlighted as a novel mechanism and potential target for neuronal recovery. The progress in mechanistic studies in the field of neurotrophic factor-mediated neuroprotection and neural regeneration, aiming at a complete understanding of integrated pathways, offers possibilities for the development of novel neuroregenerative therapeutic approaches.

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“…One older meta-analysis of pharmacological interventions in bipolar disorder states that there were no robust data available to assess the effectiveness of lithium in treating bipolar depression (Selle et al, 2014). Two recent systematic reviews and meta-analysis reached the same conclusion (Fountoulakis et al, 2022;Rakofsky et al, 2022). At the same time, several guidelines like those from the "Canadian Network for Mood and Anxiety Treatments" (CANMAT) and the "International Society for Bipolar Disorders" (ISBD) (Yatham et al, 2018) advise treatment of bipolar depression with lithium and recommend a target serum concentration of 0.8-1.2 mmol/L.…”

Section: Introductionmentioning

confidence: 98%

Lithium in bipolar depression: A review of the evidence

Riedinger,

van der Wee,

Giltay

et al. 2023

Human Psychopharmacology

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BackgroundLithium is widely used as treatment of acute mania and as prophylactic therapy for bipolar disorder. International and national guidelines also consider lithium as a possible treatment of acute bipolar depression. Research on the use of lithium in bipolar depression, however, seems to be limited compared to the data available for its efficacy in the other phases of bipolar disorder.ObjectiveTo provide a systematic review of the evidence for lithium in the treatment of acute bipolar depression and provide directions for further research.MethodA systematic review of clinical studies investigating the use of lithium in bipolar depression was performed using preferred reporting items for systematic reviews and meta‐analyses guidelines in Pubmed, Embase and Psychinfo using the medical subjects headings and free text terms “lithium,” “bipolar depression,” “dosage,” “serum concentration” and “bipolar disorders.”ResultsThis review included 15 studies with a total of 1222 patients, between the age of 18 and 65, suffering from bipolar depression of which 464 were treated with lithium. There are currently only limited and low‐quality data on the efficacy of lithium as a treatment of bipolar depression. It appears that there have been no placebo controlled randomized controlled trials with lithium concentrations that are considered to be therapeutic. The older studies suffered from limitations such as small sample sizes, insufficient treatment lengths, and insufficient monitoring of serum concentrations.ConclusionIn contrast to data for the treatment of mania and prophylaxis, robust data on the efficacy of lithium in bipolar depression is currently lacking, making it impossible to make conclusions regarding efficacy or inefficacy, for which further research is needed.

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Lithium in the treatment of acute bipolar depression: A systematic review and meta-analysis

Cited by 16 publications

References 54 publications

Appropriate Macronutrients or Mineral Elements Are Beneficial to Improve Depression and Reduce the Risk of Depression

Appropriate Macronutrients or Mineral Elements Are Beneficial to Improve Depression and Reduce the Risk of Depression

The Role of Metals in the Neuroregenerative Action of BDNF, GDNF, NGF and Other Neurotrophic Factors

Lithium in bipolar depression: A review of the evidence

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