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low dose lithium and suicide

Sivan Mauer, Derick Vergne, S Nassir Ghaemi
OBJECTIVE: Dementia is a major public health issue, with notably high rates in persons with mood illnesses. Lithium has been shown to have considerable neuroprotective effects, even in trace or low doses. The aim of this review is to summarize the current understanding of lithium benefits in trace or low doses in dementia prevention and for other behavioral or medical benefits. METHODS: A systematic review identified 24 clinical, epidemiological, and biological reports that met inclusion criteria of assessing lithium in standard or low doses for dementia or other behavioral or medical benefits...
September 2014: Australian and New Zealand Journal of Psychiatry
Victor Blüml, Michael D Regier, Gerald Hlavin, Ian R H Rockett, Franz König, Benjamin Vyssoki, Tom Bschor, Nestor D Kapusta
There is increasing evidence from ecological studies that lithium levels in drinking water are inversely associated with suicide mortality. Previous studies of this association were criticized for using inadequate statistical methods and neglecting socioeconomic confounders. This study evaluated the association between lithium levels in the public water supply and county-based suicide rates in Texas. A state-wide sample of 3123 lithium measurements in the public water supply was examined relative to suicide rates in 226 Texas counties...
March 2013: Journal of Psychiatric Research
B Alevizos, E Alevizos, A Leonardou, I Zervas
Lithium augmentation is one of the best studied strategies for resistant depression. The lithium dosage usually given is around 900 mg/day and plasma level is maintained in the range of 0.5-0.8 mEq/L. However, the administration of lithium in this dosage necessitates monitoring of plasma concentration and increases the risk of toxicity and side effects. Since it has been shown that low lithium levels increase serotonin turnover and enhance serotonin neurotransmission, we thought it of interest to assess the efficacy of low dosage lithium augmentation for patients with resistant depression...
April 2012: Psychiatrikē, Psychiatriki
Andrew A Nierenberg, Louisa G Sylvia, Andrew C Leon, Noreen A Reilly-Harrington, Terence A Ketter, Joseph R Calabrese, Michael E Thase, Charles L Bowden, Edward S Friedman, Michael J Ostacher, Lena Novak, Dan V Iosifescu
BACKGROUND: Recent data indicate that lithium use for bipolar disorder has declined over the last decade and that lithium largely has been replaced with alternate, commercially promoted medications that may or may not result in better outcomes. PURPOSE: This article describes the rationale and study design of LiTMUS, a multi-site, prospective, randomized clinical trial of outpatients with bipolar disorder. LiTMUS seeks to address whether initiating therapy at lower doses of lithium as part of optimized treatment (OPT, guideline-informed, evidence-based, and personalized pharmacotherapy) improves outcomes and decreases the need for other medication changes across 6 months of therapy...
December 2009: Clinical Trials: Journal of the Society for Clinical Trials
Hirochika Ohgami, Takeshi Terao, Ippei Shiotsuki, Nobuyoshi Ishii, Noboru Iwata
Although lithium is known to prevent suicide in people with mood disorders, it is uncertain whether lithium in drinking water could also help lower the risk in the general population. To investigate this, we examined lithium levels in tap water in the 18 municipalities of Oita prefecture in Japan in relation to the suicide standardised mortality ratio (SMR) in each municipality. We found that lithium levels were significantly and negatively associated with SMR averages for 2002-2006. These findings suggest that even very low levels of lithium in drinking water may play a role in reducing suicide risk within the general population...
May 2009: British Journal of Psychiatry: the Journal of Mental Science
M Tournier, A Grolleau, A Cougnard, H Verdoux, M Molimard
INTRODUCTION: Psychotropic drugs belong to the drugs most frequently involved in intentional drug overdose (IDO). Few studies have explored their prognostic impact during hospitalisation for IDO. METHODS: In order to assess which types of psychotropic drugs ingested during IDOs were associated with an increased morbidity, a cohort study included 1,974 patients consecutively hospitalised for IDO. IDOs were categorised as serious if associated with one of the following criteria: death, hospitalisation longer than 48 h, respiratory support, vasopressive drugs, cardiac massage or dialysis...
March 2009: Pharmacopsychiatry
J Greenhalgh, C Knight, D Hind, C Beverley, S Walters
OBJECTIVES: To establish the clinical effectiveness and cost-effectiveness of electroconvulsive therapy (ECT) for depressive illness, schizophrenia, catatonia and mania. DATA SOURCES: Electronic bibliographic databases. The reference lists of relevant articles and health services research-related resources were consulted via the Internet. REVIEW METHODS: Identified studies were examined to ascertain whether they met the inclusion criteria for the review...
March 2005: Health Technology Assessment: HTA
C Debien, M B De Chouly De Lenclave, P Foutrein, D Bailly
UNLABELLED: The interferon alpha stands as a reference both in oncology and virology. But its efficiency is limited by frequent somatic as well as neuropsychic side effects. As a matter of fact, the reduction or the ending of a chemotherapy treatment come chiefly from the psychiatric complications caused by the use of interferon. For about 30% of patients, various psychic disorders are noticed: personality disorders, mood disorders, anxiety states, suicidal tendencies, manic and psychotic symptoms...
July 2001: L'Encéphale
C L Bowden
Lithium was introduced in 1949 as a treatment for mania, for which there is still the strongest evidence of its efficacy. It has consistently yielded better results in the treatment of mania than neuroleptics and carbamazepine and equivalent results to divalproex. Its efficacy in bipolar depression remains inadequately studied. Lithium also provides benefit in prophylaxis. However, the percentage of patients persistently benefited is low, because it has both low efficacy in many symptomatic and illness course presentations of the disorder and low tolerability...
2000: Journal of Clinical Psychiatry
A Pelissolo, J P Lepine
The pharmacotherapy of personality disorders is less developed than are psychological treatments in this area, but they are a logical prolongation of psychobiological models of personality and temperament, and respond to the need of many clinicians in front of difficult patients. The assessment of drugs effects in personality disorders includes some important conceptual and methodological issues. Categorical or dimensional instruments evaluating baseline personality and under-treatment changes are now available...
September 1999: L'Encéphale
H B Rothenhäusler, H P Kapfhammer
This paper reviews the current state of research results on borderline disorders in terms of course and outcome, variables predisposing to good or poor outcome, suicide rates and the influence of psychotherapeutical and pharmacotherapeutical strategies. It turned out that course and outcome of borderline disorders depend on the applied diagnostic criteria and on the length of the follow-up period. The outcome of the follow-up studies of borderline schizophrenia and of the borderline syndrome according to Grinker was on the whole worse compared to those of borderline personality disorder defined by DSM-III/III-R or DIB according to Gunderson or Kernberg's criteria...
May 1999: Fortschritte der Neurologie-Psychiatrie
O C Pinto, H S Akiskal
BACKGROUND: Borderline personality disorder (BPD) has long defined definitive treatment. Such failure is reflected in repeated suicidal crises, often associated with dysphoric symptoms of a chronic fluctuating nature, whose labile intermittent character does suggest a subthreshold bipolar depressive mixed state. For all these reasons, we hypothesized that the anticonvulsant lamotrigine, touted to be a mood stabilizer with antidepressant properties, might be uniquely beneficial for these patients...
December 1998: Journal of Affective Disorders
A Hori
Double-blind, placebo-controlled trials of pharmacotherapy for personality disorders (PD) were reviewed, and the indications concluded were as follows: (1) Severe cases of both Borderline Personality Disorder (BDP) and Schizotypal Personality Disorder (SPD) respond to low dose antipsychotic drugs resulting in improvement of a broad spectrum of symptoms. They also respond to monoamine oxidase inhibitor (MAOI). Amitriptyline causes a paradoxical effect. (2) Borderline personality disorder with behavioral dyscontrol responds to carbamazepine which reduces actual episodes of dyscontrol, to an antipsychotic drug and to MAOI...
February 1998: Psychiatry and Clinical Neurosciences
H Y Meltzer
Treatment-resistant schizophrenia is the object of intense interest because of recent developments in its treatment and aetiology. The actual definition of treatment-resistant schizophrenia is, however, still controversial. It should reflect the legitimate and varied needs and perspectives of people with schizophrenia, their family members, mental health care givers, mental health administrators, public health officials, and those who fund the direct and indirect costs of treating schizophrenia. The most common definition of treatment-resistant schizophrenia denotes patients with schizophrenia who, despite at least two adequate trials of classical neuroleptic drugs, have persistent moderate to severe positive, or disorganisation, or negative symptoms together with poor social and work function over a prolonged period of time...
1997: Current Medical Research and Opinion
A Koukopoulos, L Pani, G Serra, G Minnai, D Reginaldi
A mixed affective syndrome is described which meets the criteria for major depression but not those of the DSM III-R for a mixed state. The clinical picture is characterized by lack of motor retardation and fluent verbalization; the facial expression is animated and sometimes dramatic. Patients suffer considerably and are often tearful. They complain of inner tension and restlessness, racing thoughts and despair. Emotional lability and momentary irritability are observed. Insomnia occurs initially or with frequent early waking...
December 1995: L'Encéphale
M Schou
A combined literature study and correspondence follow-up provided information about the development and further course of long-lasting neurological sequelae after lithium intoxication in 40 patients (28 women and 12 men). The circumstances surrounding the acute intoxications were examined. Possible precipitating circumstances included somatic illness with fever (11 cases), concurrent treatment with low-salt diet and diuretics, major surgery, low food intake, recent start with large lithium doses, acute overdose with suicidal intent, overdose due to pharmacy, laboratory or patient mistakes, and concurrent treatment with large doses of haloperidol in the presence of fever...
December 1984: Acta Psychiatrica Scandinavica
A Nilsson, R Axelsson
Sixty-four outpatients with major affective disorder according to DSM-III and on continuous lithium treatment for an average duration of 7.8 years were first investigated in 1980 and then followed for 7 years. The predictive value of patients' attitudes to their lithium, the prognostic influence of psychiatric status, side effects, and anamnestic and laboratory data including lithium parameters were studied. At the end of the 7-year follow-up, 61% of the patients were still on lithium maintenance treatment, 25% had discontinued lithium for clinical reasons, and 14% of the patients had died...
September 1989: Acta Psychiatrica Scandinavica
G N Schrauzer, K P Shrestha
Using data for 27 Texas counties from 1978-1987, it is shown that the incidence rates of suicide, homicide, and rape are significantly higher in counties whose drinking water supplies contain little or no lithium than in counties with water lithium levels ranging from 70-170 micrograms/L; the differences remain statistically significant (p less than 0.01) after corrections for population density. The corresponding associations with the incidence rates of robbery, burglary, and theft were statistically significant with p less than 0...
May 1990: Biological Trace Element Research
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