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Lithium and peripheral nervous system function in manic-depressive patients

S Podnar1, D B Vodusek, V Zvan

  • 1Institute of Clinical Neurophysiology, University Medical Centre, Ljubljana, Slovenia.

Acta Neurologica Scandinavica
|December 1, 1993
PubMed
Summary

Lithium treatment may cause minor nerve damage in psychiatric patients, affecting both motor and sensory axons. This subclinical axonopathy is slightly more pronounced in those on lithium therapy.

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Area of Science:

  • Neuroscience
  • Clinical Neurology
  • Psychopharmacology

Background:

  • Lithium salts are standard treatment for affective disorders.
  • Lithium can cause peripheral nervous system changes, even within therapeutic ranges.
  • The study evaluates lithium's risk versus other factors affecting peripheral nerves in psychiatric patients.

Purpose of the Study:

  • To assess electrophysiologic peripheral nerve function in lithium-treated patients, untreated affective psychotic patients, and healthy controls.
  • To compare the risk of lithium treatment to other potential causes of peripheral neuropathy in psychiatric patients.

Main Methods:

  • Electrophysiologic testing of motor and sensory peripheral nerve fibers.
  • Comparison of two age-matched groups of psychiatric patients (20 lithium-treated, 20 untreated) and 20 healthy volunteers.

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Main Results:

  • Both patient groups showed lower M wave and sensory nerve action potential amplitudes on median nerve stimulation.
  • Lithium-treated patients uniquely exhibited lower M wave amplitudes on peroneal nerve stimulation.
  • No significant differences in nerve conduction velocities were observed between groups.

Conclusions:

  • Affective-psychotic patients exhibit subclinical axonal involvement, slightly exacerbated by lithium treatment.
  • Lithium, within therapeutic levels, is considered one factor contributing to minor axonopathy in psychiatric patients.
  • Further research may explore the multifactorial nature of peripheral nerve involvement in this population.