Lithium Still Bipolar's Treatment of Choice

Lithium still most effective despite concerns of negative side effects

(RxWiki News) At one time lithium was a common drug treatment for bipolar disorder, also known as manic-depressive disorder. But its use has decreased significantly, partly due to concerns about safety and its possible negative effect on kidney function.

A new study has researched these side effects and possibly safety drawbacks of lithium. Researchers found that doctors should feel confident in prescribing the drug for people who suffer from bipolar disorder as the most effective long-term treatment.

"Ask your doctor if lithium is the most effective choice for you."

At Oxford University in England, a team of researchers led by Professor John Geddes assessed almost 400 articles investigating the possible adverse effects of lithium.

Geddes and his team found that the drug is related to an increased risk of abnormalities in the thyroid and parathyroid glands, occurring in about 25 percent of patients on lithium therapy (compared to three percent and 0.1 percent in the general population).

Lithium can also cause weight gain, and can slightly reduce the kidneys' ability to concentrate urine. However, some of the most serious concerns with the drug remain uncertain, such as a link in birth defects for pregnant women on lithium treatment.

Researchers found very little evidence linking lithium with hair loss or skin problems.

The drug's benefits and success in treating both depression and mania have been proven, and it has been shown to reduce the risk of suicide in such patients. Geddes and his team recommend testing for calcium levels to assess the risk of parathyroid side effects, and that all possible side effects should be discussed with a patient prior to starting lithium.

When it comes to the effectiveness of lithium, the study "reaffirms its role as a treatment of choice for bipolar disorder," according to Dr. Gin Malhi and Dr. Michael Berk, in an accompanying editorial article.

The research was funded by the UK National Institute for Health Research. Findings were published in the January 2012 issue of The Lancet.

Review Date: 
January 25, 2012