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Use of Lithium in Pediatric Bipolar Disorders and Externalizing Childhood- related Disorders: A Systematic Review of

Delfina Janiri1,2, Lorenzo Moccia1,2, Silvia Montanari1

  • 1Department of Geriatrics, Institute of Psychiatry and Psychology, Neuroscience and Orthopedics, Catholic University of the Sacred Heart, Largo Francesco Vito 1, Rome, 00168, Italy.

Current Neuropharmacology
|January 27, 2023
PubMed

Insights

Lithium is an effective treatment for pediatric bipolar disorder (BD) and conduct disorder (CD), showing good tolerability. However, more research is needed to fully understand its use in children and adolescents.

Area of Science:

  • Child and Adolescent Psychiatry
  • Pharmacology
  • Neuroscience

Background:

  • Limited data exists on lithium use in pediatric bipolar disorder (BD).
  • This review investigates lithium's efficacy in pediatric BD and externalizing disorders.
  • Lithium is a standard adult BD treatment.

Approach:

  • Systematic review following PRISMA criteria.
  • Included randomized controlled trials for pediatric BD, conduct disorder (CD), ADHD, ODD, and DMDD.
  • Primary outcome: lithium efficacy vs. placebo/other agents; secondary: acceptability and tolerability.

Key Points:

  • 8 studies on BD (673 patients) and 4 on CD (184 patients) were included.
  • Lithium superior to placebo for pediatric BD manic/mixed episodes; inferior to antipsychotics.
  • Lithium showed efficacy in CD, particularly for aggressive behaviors.
  • High comorbidity (98.6%) between BD and externalizing disorders observed.
  • Common side effects were similar to adults; no severe adverse events reported.

Conclusions:

  • Lithium is an efficacious and well-tolerated treatment for pediatric BD and CD.
  • Evidence is limited by the scarcity of available pediatric data.
  • Further research is warranted to expand the evidence base.
Abstract

Keywords:
Lithiumbipolar disorderchildrenconduct disorderexternalizing disorderpediatric

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