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Association between lithium and arterial atherosclerosis in physically healthy bipolar disorder

Shang-Ying Tsai1, Ting-Hsuan Chang2, Martha Sajatovic3

  • 1Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Psychiatry, Taipei Medical University Hospital, Taipei, Taiwan.

Journal of Affective Disorders
|June 9, 2026
PubMed

Insights

Higher serum lithium levels correlate with reduced atherosclerosis in bipolar disorder (BD) patients. Maintaining healthy weight and managing illness duration are crucial for cardiovascular health in BD.

Area of Science:

  • Cardiology
  • Psychiatry
  • Pharmacology

Background:

  • Bipolar disorder (BD) patients face increased cardiovascular disease (CVD) risk, mainly due to atherosclerosis.
  • Identifying factors contributing to atherosclerosis in medicated BD patients is crucial for risk management.

Purpose of the Study:

  • To investigate clinical and medication-related factors associated with accelerated atherosclerosis in bipolar I disorder patients.
  • To assess the relationship between serum lithium levels, illness duration, and carotid intima-media thickness (CIMT).

Main Methods:

  • Carotid intima-media thickness (CIMT) was measured in 110 bipolar I disorder patients and 107 controls using ultrasonography.
  • Clinical data, including illness duration, BMI, and serum lithium levels, were collected.
  • Statistical analyses, including multivariable logistic regression, were performed to identify associations.

Main Results:

  • Bipolar disorder patients exhibited significantly higher mean CIMT compared to controls.
  • Lower serum lithium levels (≤0.6 mEq/L) and longer illness duration were associated with increased CIMT.
  • Higher triglyceride levels and BMI were also linked to greater CIMT, with BMI being significant in lithium-treated patients.

Conclusions:

  • Higher serum lithium levels are associated with lower CIMT, suggesting a potential anti-atherosclerotic effect.
  • Illness chronicity is linked to increased atherosclerosis, highlighting the importance of long-term management.
  • Weight management and monitoring lithium levels are vital for reducing cardiovascular risk in bipolar disorder patients.
Abstract

Keywords:
AtherosclerosisBipolar disorderBody weightCardiovascular riskLithium

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