Lithium: updated human knowledge using an evidence-based approach: part III: clinical safety

Area of Science:

• Pharmacology
• Nephrology
• Endocrinology
• Neurology
• Psychiatry

Background:

• Lithium remains a cornerstone treatment for bipolar disorders.
• Understanding its safety profile is crucial for optimal patient management.
• This review focuses on the safety data of lithium therapy.

Purpose of the Study:

• To review available safety data on lithium therapy.
• To highlight common and rare adverse effects associated with lithium use.
• To emphasize the importance of monitoring lithium treatment.

Main Methods:

• Review of existing literature on lithium safety.
• Analysis of reported adverse events and complications.
• Evaluation of risks associated with long-term lithium therapy.

Main Results:

• Common side effects include gastrointestinal issues, tremor, polyuria, weight gain, and psoriasis exacerbation.
• Renal effects range from reduced concentrating capacity to nephrogenic diabetes insipidus and potential glomerular impairment.
• Thyroid dysfunction (hypothyroidism, goiter) and hyperparathyroidism are notable endocrine effects.
• Neurological effects include tremor, and rarely, more severe symptoms; cognitive disturbances are also reported.
• Pregnancy and breastfeeding require careful consideration due to potential risks.

Conclusions:

• Thorough knowledge of lithium's limitations and drawbacks is mandatory for its optimal use.
• Risk-benefit assessment is critical, especially when comparing with alternative mood stabilizers.
• Close monitoring for adverse effects is essential for patients on long-term lithium therapy.