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Lithium-associated hypercalcemia and hyperparathyroidism in the elderly: what do we know?
1The Johns Hopkins University School of Medicine, 600 North Wolfe Street, Meyer 279, Baltimore, Maryland 21287-7279, United States. slehman@jhmi.edu
Journal of Affective Disorders
|September 19, 2012
Summary
Lithium therapy can cause hypercalcemia and hyperparathyroidism, particularly in older adults. Regular screening for these conditions is crucial in elderly patients receiving lithium treatment.
Area of Science:
- Endocrinology
- Psychiatry
- Geriatrics
Background:
- Lithium is a common treatment for bipolar disorder.
- Lithium use is associated with hypercalcemia and hyperparathyroidism.
- Limited research exists on these effects in older populations.
Purpose of the Study:
- To review the impact of lithium on calcium and parathyroid hormone levels in older patients.
- To assess the prevalence and clinical significance of lithium-associated hypercalcemia and hyperparathyroidism in the elderly.
Main Methods:
- Systematic review of English-language articles.
- Searches conducted through PubMed database.
- Included studies reporting on lithium-associated hypercalcemia and/or hyperparathyroidism.
Main Results:
- 40% of reported cases of lithium-associated hyperparathyroidism involved individuals over 60.
- Older patients (over 60) on lithium showed higher mean serum calcium levels compared to younger patients.
- Symptomatic complications may be more prevalent in older patients, especially with co-existing renal disease.
Conclusions:
- Lithium-induced hypercalcemia and hyperparathyroidism are under-recognized in older patients.
- Vigilant screening for these conditions is recommended for elderly patients on lithium.
- Screening should occur before initiating lithium and at least annually thereafter.
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