Long-term effects of lithium on renal, thyroid, and parathyroid function: a retrospective analysis of laboratory data

Shine, Brian; McKnight, Rebecca; Leaver, Laurence; Geddes, John

doi:10.1016/s0140-6736(14)61842-0

Cited by 225 publications

(194 citation statements)

References 24 publications

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“…Özerdem et al (45) showed a higher rate of TSH abnormality in female patients with bipolar disorder who were taking lithium (45). Similar to our results, other studies have shown a greater susceptibility to thyroid dysfunction and thyroid disorder among female subjects (18,21,44). One study reported that the duration of lithium treatment was related with the development of goiter; however, we did not find such an association in our study (3).…”

Section: Discussionsupporting

confidence: 85%

“…The reported prevalence of lithium-associated hypothyroidism varies widely in the literature, from 3.4% to 52% (3,4,10,12,13,14,15,16,17,18,19,20,21). Johnston and Eagles reported that when lithium-associated hypothyroidism occurs, it is usually subclinical; however, in the present study, 14 (16.7%) cases of hypothyroidism and 7 (8.3%) cases of subclinical hypothyroidism were diagnosed in the lithium group (15).…”

Section: Discussioncontrasting

confidence: 60%

“…The prevalence rates of hypothyroidism range from 3.4% to 52% in various studies (3,4,10,12,13,14,15,16,17,18,19,20,21). The female to male ratio is approximately five to one.…”

Section: Introductionmentioning

confidence: 98%

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Thyroid Function and Ultrasonography Abnormalities in Lithium-Treated Bipolar Patients: A Cross-sectional Study with Healthy Controls

Tunçel

Akdeniz

Özbek

et al. 2017

Arch Neuropsychiatr

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Introduction: Lithium has many effects on thyroid physiology. Although these side effects have been known for a long time, large sample studies of lithium-treated patients using ultrasonography are lacking. The aim of this study is to investigate the detailed thyroid morphologies, hormone levels, and antibodies of lithium-treated patients compared with healthy controls.Methods: This cross-sectional study involved 84 lithium-treated patients with bipolar disorder and 65 gender and age similar controls who had never been exposed to lithium. Subjects between 18 and 65 years of age were eligible for the study. Venous blood samples were acquired to determine the levels of free thyroxine (fT4), thyroid stimulating hormone (TSH), and thyroid antibodies; also, ultrasonographic examinations of the patients' thyroid glands were performed.Results: There were no statistically significant differences in smoking habits, known thyroid disease, thyroid medication use, familial thyroid disease, fT4 level, autoimmunity, thyroid nodule presence, or Hashimoto' s thyroiditis between the lithium and control groups. The median TSH level and thyroid volume were significantly higher in the lithium group. In the lithium group, 14 cases (16.7%) of hypothyroidism, seven cases (8.3%) of subclinical hypothyroidism, and one case (1.2%) of subclinical hyperthyroidism were defined; in the control group, seven cases (10.8%) of hypothyroidism and two cases (3.1%) of subclinical hyperthyroidism were defined. Thyroid dysfunction, goiter, parenchymal abnormality, ultrasonographically defined thyroid abnormality, and thyroid disorder were found to be more prevalent in the lithium group. 90% of patients with goiter and 74.3% of patients with ultrasonographic pathologies were euthyroid. Conclusion:It is important to note that 90% of the patients with goiter were euthyroid. This indicates that monitoring by blood test alone is insufficient. The prevalence rates of 47.6% for goiter and 83.3% for ultrasonographic pathology demonstrate that ultasonographic follow-up may be useful in lithium-treated patients. To determine whether routine ultrasonographic examination is necessary, large sample prospective studies are necessary due to the limitations of this study.

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Section: Discussionsupporting

confidence: 85%

Section: Discussioncontrasting

confidence: 60%

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Thyroid Function and Ultrasonography Abnormalities in Lithium-Treated Bipolar Patients: A Cross-sectional Study with Healthy Controls

Tunçel

Akdeniz

Özbek

et al. 2017

Arch Neuropsychiatr

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“…Nonsteroidal anti-inflammatory drugs (NSAIDs), thiazide diuretics, and angiotensin-converting enzyme (ACE) inhibitors are the drugs which could changed lithium dosage. Also, diabetes insipidus, low salt diet, being over 50 years old and deterioration in renal function could be risk factors for lithium intoxication (1). As seen, the common features, drugs and situations which change lithium serum levels are effective on kidney cell and ion.…”

Section: Discussionmentioning

confidence: 99%

“…Interaction of lithium with several nonsteroidal anti-inflammatory drugs (NSAIDs), thiazide diuretics, and angiotensinconverting enzyme (ACE) inhibitors have been commonly reported. Additionally, diabetes insipidus, low salt diet, over 50 years old, hypothyroidism and deterioration in renal function could be risk factors for lithium intoxication (1). With lithium treatment side effects in many organ systems could be seen.…”

Section: Introductionmentioning

confidence: 99%

Elevated Blood Lithium Concentration following Concomitant Lithium and Propranolol Therapy: A Case Report

Çim¹,

Cecen²

2018

Eastern J Med

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Diagnosis and Treatment of Bipolar Disorder

Nierenberg,

Agustini,

Köhler-Forsberg

et al. 2023

JAMA

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ImportanceBipolar disorder affects approximately 8 million adults in the US and approximately 40 million individuals worldwide.ObservationsBipolar disorder is characterized by recurrent episodes of depression and mania or hypomania. Bipolar depressive episodes are similar to major depressive episodes. Manic and hypomanic episodes are characterized by a distinct change in mood and behavior during discrete time periods. The age of onset is usually between 15 and 25 years, and depression is the most frequent initial presentation. Approximately 75% of symptomatic time consists of depressive episodes or symptoms. Early diagnosis and treatment are associated with a more favorable prognosis. Diagnosis and optimal treatment are often delayed by a mean of approximately 9 years following an initial depressive episode. Long-term treatment consists of mood stabilizers, such as lithium, valproate, and lamotrigine. Antipsychotic agents, such as quetiapine, aripiprazole, asenapine, lurasidone, and cariprazine, are recommended, but some are associated with weight gain. Antidepressants are not recommended as monotherapy. More than 50% of patients with bipolar disorder are not adherent to treatment. Life expectancy is reduced by approximately 12 to 14 years in people with bipolar disorder, with a 1.6-fold to 2-fold increase in cardiovascular mortality occurring a mean of 17 years earlier compared with the general population. Prevalence rates of metabolic syndrome (37%), obesity (21%), cigarette smoking (45%), and type 2 diabetes (14%) are higher among people with bipolar disorder, contributing to the risk of early mortality. The annual suicide rate is approximately 0.9% among individuals with bipolar disorder, compared with 0.014% in the general population. Approximately 15% to 20% of people with bipolar disorder die by suicide.Conclusions and RelevanceBipolar disorder affects approximately 8 million adults in the US. First-line therapy includes mood stabilizers, such as lithium, anticonvulsants, such as valproate and lamotrigine, and atypical antipsychotic drugs, such as quetiapine, aripiprazole, asenapine, lurasidone, and cariprazine.

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Long-term effects of lithium on renal, thyroid, and parathyroid function: a retrospective analysis of laboratory data

Abstract: None.

Cited by 225 publications

References 24 publications

Thyroid Function and Ultrasonography Abnormalities in Lithium-Treated Bipolar Patients: A Cross-sectional Study with Healthy Controls

Thyroid Function and Ultrasonography Abnormalities in Lithium-Treated Bipolar Patients: A Cross-sectional Study with Healthy Controls

Elevated Blood Lithium Concentration following Concomitant Lithium and Propranolol Therapy: A Case Report

Diagnosis and Treatment of Bipolar Disorder

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