Oxford study on lithium for treatment of bipolar disorder
By Liz Lockhart
According to an Oxford University study, doctors should feel confident in prescribing lithium for patients with bipolar disorder. 
The research team was led by Professor John Geddes and the results are published in The Lancet.
The researchers set out to investigate the potential side effects of lithium, as it is considered to be the most effective long-term treatment for bipolar disorder and yet it is less commonly prescribed due to concerns about the drug’s side effects, particularly on the kidneys.
It is currently estimated that one person in 100 has bipolar disorder and is, therefore, a relatively common condition. People with bipolar disorder experience mood swings with periods of depression and mania. These feelings can last for weeks or even longer. The periods of feeling high and low can be so severe that they impede everyday life. Lithium is claimed to calm both mania and depression whilst also reducing the risk of suicide. You can read more about bipolar disorder here.
Professor Geddes and his team decided that because patients could benefit from lithium but may not be offered it due to the possibility of negative side effects, they would investigate these side effects further.
Nearly 400 articles concerning the possible side effects of lithium were reviewed by the researchers. They made several recommendations which were designed to guide lithium treatment in the future.
The researchers suggest that there is a definite increased risk of abnormalities in the thyroid and parathyroid glands which equates to about 25% of patients who take lithium compared to3% in the general population.
It was also found that lithium use promotes weight gain and can slightly reduce the kidneys’ ability to concentrate urine. However, evidence which links birth defects with lithium use during pregnancy is still inconclusive according to this study. It also finds that there is very little proof to link the use of lithium with skin problems and hair loss.
The team recommends that GPs discuss the risk of side effects with patients prior to starting lithium treatment. They also suggest that the introduction of calcium levels of blood tests would be of benefit because of the risk of hyperparathyroidism. Hyperparathyroidism is the excessive production of parathyroid hormone (PTH) by the parathyroid glands.
Furthermore, the researchers feel that the uncertainty regarding birth defects should be discussed with women of childbearing age, rather than not recommending lithium during pregnancy.
More research is needed on the association between lithium and the kidneys, according to Geddes and his team.
Source: Oxford University
