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Lithium as a Treatment for Alzheimer's Disease: A Systematic Review and Meta-Analysis
Shinji Matsunaga1, Taro Kishi1, Peter Annas2
1Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Aichi, Japan.
Background:
This is the first meta-analysis of randomized placebo-controlled trials testing lithium as a treatment for patients with Alzheimer's disease (AD) and individuals with mild cognitive impairment (MCI).
Methods:
The primary outcome measure was efficacy on cognitive performance as measured through the Alzheimer's Disease Assessment Scale cognitive subscale or the Mini-Mental State Examination. Other outcome measures were drug discontinuation rate, individual side effects, and biological markers (phosphorylated tau 181, total tau, and amyloid-β42) in cerebrospinal fluid (CSF).
Results:
Three clinical trials including 232 participants that met the study's inclusion criteria were identified. Lithium significantly decreased cognitive decline as compared to placebo (standardized mean difference = -0.41, 95% confidence interval = -0.81 to -0.02, p = 0.04, I2 = 47% , 3 studies, n = 199). There were no significant differences in the rate of attrition, discontinuation due to all causes or adverse events, or CSF biomarkers between treatment groups.
Conclusions:
The results indicate that lithium treatment may have beneficial effects on cognitive performance in subjects with MCI and AD dementia.
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