The Full Story of Lithium

Bech, Per

doi:10.1159/000093947

Cited by 29 publications

(9 citation statements)

References 35 publications

(33 reference statements)

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“…Later, Mogens Schou (1918–2005) undertook a randomized controlled trial of lithium in mania (Schou et al, 1954; Bech, 2006), and eventually the the efficacy of lithium during the maintenance phase was established (Gershon and Yuwiler, 1960; Baastrup, 1964; Baastrup and Schou, 1967; Angst et al, 1969, 1970; Baastrup et al, 1970; Schou et al, 1970; Johnstone et al, 1988; Schioldann, 1999; Mitchell and Hadzi-Pavlovic, 2000; Bech, 2006; Schioldann, 2006; Schioldann, 2011). …”

Section: Introductionmentioning

confidence: 99%

The International College of Neuropsychopharmacology (CINP) Treatment Guidelines for Bipolar Disorder in Adults (CINP-BD-2017), Part 1: Background and Methods of the Development of Guidelines

Fountoulakis

Young

Yatham

et al. 2016

IJNPPY

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Background:This paper includes a short description of the important clinical aspects of Bipolar Disorder with emphasis on issues that are important for the therapeutic considerations, including mixed and psychotic features, predominant polarity, and rapid cycling as well as comorbidity.Methods:The workgroup performed a review and critical analysis of the literature concerning grading methods and methods for the development of guidelines.Results:The workgroup arrived at a consensus to base the development of the guideline on randomized controlled trials and related meta-analyses alone in order to follow a strict evidence-based approach. A critical analysis of the existing methods for the grading of treatment options was followed by the development of a new grading method to arrive at efficacy and recommendation levels after the analysis of 32 distinct scenarios of available data for a given treatment option.Conclusion:The current paper reports details on the design, method, and process for the development of CINP guidelines for the treatment of Bipolar Disorder. The rationale and the method with which all data and opinions are combined in order to produce an evidence-based operationalized but also user-friendly guideline and a specific algorithm are described in detail in this paper.

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Section: Introductionmentioning

confidence: 99%

The International College of Neuropsychopharmacology (CINP) Treatment Guidelines for Bipolar Disorder in Adults (CINP-BD-2017), Part 1: Background and Methods of the Development of Guidelines

Fountoulakis

Young

Yatham

et al. 2016

IJNPPY

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“…Discovered by Johan Arfwedson in 1817, lithium was used for the first time in medicine in 1843 by Alexander Ure [1] . Lithium's effects on manic-depressive illness were discovered by chance in 1949 by John Cade who observed its sedating effect [2,3] . Mogens Schou established the effectiveness of lithium for the treatment of bipolar disorder (BD) [4] .…”

Section: Introductionmentioning

confidence: 99%

Lithium: Still a Cornerstone in the Long-Term Treatment in Bipolar Disorder?

2010

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Background: Scientific literature considers lithium a key treatment for the acute and long-term management of bipolar disorder (BD). Despite its worldwide clinical use, the effectiveness of lithium has been questioned. The aim of this work is to critically review the available data on randomized controlled trials (RCTs) concerning long-term lithium treatment. Methods: A systematic search for long-term treatment RCTs with at least 6 months of follow-up was performed. Six RCTs enrolling 1,561 bipolar I and II patients of adult and pediatric age, randomizing 534 to lithium, were identified. All studies are controlled trials sponsored by industry, investigating new treatments for BD, with lithium as an active comparator, and therefore not specifically designed to study lithium efficacy or safety. Results: Results from earliest studies suggest a high effectiveness of lithium against both mania and depression, while more recent studies highlight lithium as more effective than placebo in mania and hypomania, without significant evidence in depression. Lithium does not achieve significant differences in efficacy when compared with divalproex; it seems less effective than lamotrigine in preventing depression and less effective than olanzapine in manic and mixed episodes. Conclusions: Despite a number of methodological issues (enriched designs, unbalanced samples, potential inclusion of lithium nonresponders in some studies), lithium appears to have a clear antimanic prophylactic activity and some efficacy in the prevention of depression. Lithium should still have a major role in the long-term treatment of BD.

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“…This is more than the prevalence of lithium use in people of all ages and probably due to the necessity of long-term treatment. The most important indications for lithium treatment in the elderly are bipolar disorder and unipolar depression (Bech, 2006). It is well known that lithium can cause a decline in maximum renal concentrating capacity (Umax) especially after long-term use (Vestegaard et al, 1979;Boton et al, 1987;Waller and Edwards, 1988).…”

Section: Introductionmentioning

confidence: 99%