Why is lithium treatment problematic?

With long-term use, lithium can cause chronic tubulo-interstitial nephritis, which is characterized by a decrease in the glomerular filtration rate (GFR) and may lead to chronic kidney disease (lithium nephropathy) (97, 98).

What are some problems with lithium treatment?

The most common side effects of lithium are feeling or being sick, diarrhoea, a dry mouth and a metallic taste in the mouth. Your doctor will carry out regular blood tests to check how much lithium is in your blood.

Why do doctors not prescribe lithium anymore?

In 62% of episodes, lithium was discontinued due to adverse effects, in 44% due to psychiatric reasons, and in 12% due to physical reasons interfering with lithium treatment.

Why is lithium controversial?

Since its introduction, the prescription of lithium has grown increasingly controversial due to reports of poisoning, memory loss, and the drug having a “lobotomizing effect” on patients.

Why must psychiatrists be careful when prescribing the drug lithium?

The use of lithium is limited by its narrow therapeutic window and adverse side effects, which necessitates frequent serum lithium monitoring; hence, there is a critical need for improved ways to monitor lithium levels in psychiatric patients.

A short history of lithium, and its remarkable impact on mood disorders | Explainer | ABC News

What are the two major long-term risks of lithium therapy?

Lithium also exerts antisuicidal, immunomodulatory, and neuroprotective effects. The main problems associated with long-term lithium treatment include kidney, thyroid, and probably cognitive issues.

Why is lithium stigmatized?

It is seen by patients, and some psychiatrists, as a dangerous drug. People rightly have suspicions about it. Patients say that the downsides include emotional numbing – feeling that you aren't connected with your feelings – as well as tremors,” said Dr Joseph Hayes, a psychiatrist at University College London.

What is the downside of lithium?

Call your doctor right away if you have diarrhea, vomiting, drowsiness, muscle weakness, tremors, unsteadiness, or other problems with muscle control or coordination. These may be symptoms of lithium toxicity. Make sure your doctor knows if you have a heart disorder called Brugada syndrome.

What are the dangers of lithium?

Long-term side effects

Taking lithium for long periods can affect your kidneys and your thyroid. Lithium can also cause drowsiness. Your doctor will carry out blood tests regularly to monitor how much lithium is in your blood. They will also monitor your kidney function, your thyroid gland and your parathyroid gland.

What is the downside of lithium for bipolar?

Common side effects of lithium can include: Hand tremor (If tremors are particularly bothersome, dosages can sometimes be reduced, or an additional medication can help.) Increased thirst. Increased urination.

What are the disadvantages of lithium in the treatment of mood disorders?

Maintenance treament requires prolonged daily tablet taking, and regular blood monitoring is necessary. Lithium has a range of unwanted side effects, including excessive thirst, polyuria, subjective memory disturbances, tremor, weight gain, and long‐term effects on the thyroid and kidney.

Is lithium worth it bipolar?

While there are different medications used to treat manic and depressive episodes in people with bipolar disorder, lithium is a commonly used medication. Studies suggest that lithium is very effective at both treating symptoms of bipolar disorder and preventing relapses of the condition.

Is there an alternative to taking lithium?

Current alternatives to lithium for the prevention of relapse in affective disorder are antidepressants (especially in unipolar illnesses), carbamazepine and maintenance ECT. There are numerous other potential pharmacological agents, in particular val- proate and valpromide.

What is the most concerning side effect of lithium?

Rare/serious side effects

Signs of lithium toxicity include severe nausea and vomiting, severe hand tremors, confusion, vision changes, and unsteadiness while standing or walking. These symptoms need to be addressed immediately with a medical doctor to ensure your lithium level is not dangerously high.

What is the most effective treatment for bipolar disorder?

The most effective treatment for bipolar disorder is a combination of medication and psychotherapy. Most people take more than one drug, like a mood-stabilizing drug and an antipsychotic or antidepressant.

Can lithium cause permanent brain damage?

Rarely, lithium is reported to cause irreversible, permanent neurological sequelae such as cerebellar impairment, dementia, parkinsonian syndromes, choreoathetosis, brain stem syndromes, and peripheral neuropathies.

What organs can lithium damage?

The three organ systems that may be negatively affected by lithium are the thyroid gland, kidneys and parathyroid glands.

What does lithium do to the brain?

At a neuronal level, lithium reduces excitatory (dopamine and glutamate) but increases inhibitory (GABA) neurotransmission; however, these broad effects are underpinned by complex neurotransmitter systems that strive to achieve homeostasis by way of compensatory changes.

Does lithium shorten your lifespan?

Lithium May Extend Longevity

In addition to the well-known positive effects on mood,¹⁸ lithium has also been linked with longer overall longevity. Two studies have found that individuals living in areas with even modest, low levels of lithium in the drinking water tend to live longer.

Does lithium affect your personality?

Substantial affect and mood changes are induced by lithium carbonate. Lethargy, dysphoria, a loss of interest in interacting with others and the environment, and a state of increased mental confusion were reported. No generalized effects were found in the responses to the personality inventories. 1.

What is the gold standard treatment for bipolar disorder?

Lithium is considered the gold standard treatment for bipolar disorder (BD). Current clinical guidelines and scientific evidence support its use as a first-line treatment in BD.

What is the long-term effect of lithium?

With long-term use, lithium can cause chronic tubulo-interstitial nephritis, which is characterized by a decrease in the glomerular filtration rate (GFR) and may lead to chronic kidney disease (lithium nephropathy) (97, 98).

Does lithium affect the brain long-term?

The research showed that after eight weeks of lithium treatment, the subjects had significant increases in gray matter fraction, global cortical thickness, and the thickness of frontal and parietal cortices. Volume increases were also seen for putamen, hippocampus, thalamic nuclei, and thalamic substructures.

What is the safest mood stabilizer?

The safest and most efficacious mood stabilizer combinations appear to be the mixtures of anticonvulsants and lithium, particularly valproate plus lithium.

Is there anything better than lithium for bipolar?

Lurasidone (Latuda) and Lamotrigine (Lamictal)

But lamotrigine is the better tolerated option, with few of the adverse effects that matter most to patients: weight gain, fatigue, sexual dysfunction, and long-term medical risks. Lamotrigine is better at preventing depression than it is at treating it.