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Updated: Oct 23, 2025

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Lithium-Induced Hyperparathyroidism: An Ill-defined Territory.

Vishwanath Pattan1, Balwinder Singh1, Sahar S Abdelmoneim1

  • 1Pattan, MD, Division of Endocrinology, Wyoming Medical Center, Casper, Wyoming, USA. Singh, MD, MS, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA. Abdelmoneim, MD, MSc, MS, Research Collaborator, Cardiovascular Ultrasound Imaging and Hemodynamic Laboratory, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA. Gopinath, MD, Department of Internal Medicine, University of Kansas, Wichita, Kansas, USA. Sundaresh, MD, MS, Division of Endocrinology, University of Utah School of Medicine, Salt Lake City, Utah, USA.

Psychopharmacology Bulletin
|August 23, 2021
PubMed
Summary

Lithium effectively treats bipolar disorder but can cause hyperparathyroidism. Cinacalcet managed this condition, allowing continued lithium treatment for bipolar disorder patients.

Keywords:
bipolar disordercinacalcethypercalcemiahyperparathyroidismlithium

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Area of Science:

  • Endocrinology
  • Psychiatry
  • Pharmacology

Background:

  • Lithium is a primary treatment for bipolar disorder, known for its efficacy.
  • An association between lithium use and hyperparathyroidism is documented.
  • Optimal management strategies for lithium-induced hyperparathyroidism remain unclear.

Observation:

  • A patient with bipolar disorder, an excellent lithium responder, developed hyperparathyroidism.
  • The patient was refractory to alternative mood stabilizers.
  • This clinical scenario presents a common challenge in managing lithium therapy.

Findings:

  • Medical management with cinacalcet successfully treated hyperparathyroidism.
  • Cinacalcet allowed for the continuation of lithium maintenance therapy.
  • This intervention avoided lithium discontinuation in a treatment-refractory patient.

Implications:

  • Cinacalcet offers a viable therapeutic option for managing lithium-induced hyperparathyroidism.
  • This approach may preserve the benefits of lithium for bipolar disorder patients.
  • Further research is warranted to confirm these findings and establish treatment guidelines.