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Recalibrating the risks and benefits of lithium therapy

  • Michael Berk (a1), Stephanie Cowdery (a2), Lana Williams (a2) and Gin S. Malhi (a3)
Summary

Recent data might subtly recalibrate the risk/benefit ratio of lithium, the prototypical mood stabiliser for bipolar disorder. There are hints that lithium might be associated with a reduction in dementia risk and as noted in this Journal, a surprising reduction in the risk of cancer.

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Copyright
Corresponding author
Michael Berk, Deakin University, Kitchener House, Geelong 3220, Australia. Email: mikebe@barwonhealth.org.au
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Declaration of interest

M.B. reports grants from the NIH, Cooperative Research Centre, Simons Autism Foundation, Cancer Council of Victoria, Stanley Medical Research Foundation, MBF, NHMRC, Beyond Blue, Rotary Health, Geelong Medical Research Foundation, Bristol Myers Squibb, Eli Lilly, Glaxo SmithKline, Meat and Livestock Board, Organon, Novartis, Mayne Pharma, Servier, Woolworths, Avant and the Harry Windsor Foundation, speaker support from Astra Zeneca, Bristol Myers Squibb, Eli Lilly, Glaxo SmithKline, Janssen Cilag, Lundbeck, Merck, Pfizer, Sanofi Synthelabo, Servier, Solvay and Wyeth, and consultancies to Allergan, Astra Zeneca, Bioadvantex, Bionomics, Collaborative Medicinal Development, Eli Lilly, Grunbiotics, Glaxo SmithKline, Janssen Cilag, LivaNova, Lundbeck, Merck, Mylan, Otsuka, Pfizer and Servier.

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References
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1 Martinson, L, Westman, J, Hallgren, J, Osby, U, Backlund, L. Lithium treatment and cancer incidence in bipolar disorder. Bipolar Disord 2016; 18: 3340.
2 Malhi, GS, Tanious, M, Das, P, Coulston, CM, Berk, M. Potential mechanisms of action of lithium in bipolar disorder. Current understanding. CNS Drugs 2013; 27: 135–53.
3 Pottegard, A, Hallas, J, Jensen, BL, Madsen, K, Friis, S. Long-term lithium use and risk of renal and upper urinary tract cancers. J Am Soc Nephrol 2016; 27: 249–55.
4 Zaiden, M, Stucker, F, Stengel, B, Vasiliu, V, Hummel, A, Landais, P, et al. Increased risk of solid renal tumours in lithium-treated patients. Kidney Int 2014; 86: 184–90.
5 Kessing, LV, S⊘ndergård, L, Forman, JL, Andersen, PK. Lithium treatment and risk of dementia. Arch Gen Psychiatry 2008; 65: 1331–5.
6 Pottegard, A, Ennis, ZN, Hallas, J, Jensen, BL, Madsen, K, Friis, S. Long-term use of lithium and risk of colorectal adenocarcinoma: a nationwide case-control study. Br J Cancer 2016; 114: 571–5.
7 Huang, RU, Hsieh, KP, Huang, WW, Yang, YH. Use of lithium and cancer risk in patients with bipolar disorder: population-based cohort study. Br J Psychiatry 2016; 209: 393–9.
8 Morris, G, Berk, M. The putative use of lithium in Alzheimer's disease. Curr Alzheimer Res 2016; 13: 853–61.
9 Khasraw, M, Ashley, D, Wheeler, G, Berk, M. Using lithium as a neuroprotective agent in patients with cancer. BMC Med 2012; 10: 131.
10 Hayes, JF, Marston, L, Walters, K, Geddes, JR, King, M, Osborn, DP. Lithium vs. valproate vs. olanzapine vs. quetiapine as maintenance monotherapy for bipolar disorder: a population-based UK cohort study using electronic health records. World Psychiatry 2016; 15: 53–8.
11 Cipriani, A, Hawton, K, Stockton, S, Geddes, JR. Lithium in the prevention of suicide in mood disorders: updated systematic review and meta-analysis. BMJ 2013; 346: f3646.
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The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
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Recalibrating the risks and benefits of lithium therapy

  • Michael Berk (a1), Stephanie Cowdery (a2), Lana Williams (a2) and Gin S. Malhi (a3)
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