Identifying the neuropsychiatric health effects of low-dose lithium interventions: A systematic review

TY - JOUR

T1 - Identifying the neuropsychiatric health effects of low-dose lithium interventions: A systematic review

AU - Strawbridge, Becci

AU - Kerr-Gaffney, Jess

AU - Cousins, David A.

AU - Juruena, Mario F

AU - Young, Allan

N1 - Funding Information: This paper represents independent research funded by the National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London . The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. The authors note that the content of this manuscript has not been published or submitted for publication elsewhere. Publisher Copyright: © 2022 The Authors

PY - 2023/1

Y1 - 2023/1

N2 - Background: Lithium is widely evidenced for its neuropsychiatric benefits. Advantages of ‘sub-therapeutic’ dosesare increasingly being reported, which is apposite given enduring concerns around adverse effects of ‘thera-peutic’ doses. We aimed to synthesise all available evidence from interventional studies investigating low-doselithium (LDL) across neuropsychiatric outcomes.Methods: Electronic databases were systematically searched to include studies where a group of adult humanswere treated with LDL (~serum level ≤0.6 mmol/L), where data describing a neuropsychiatric outcome werereported either before and after treatment, and/or between lithium and a comparator.Results: 18 articles were examined and grouped according to outcome domain (cognition, depression, mania, andrelated constructs e.g., suicidality). Significant benefits (versus placebo) were identified for attenuating cognitivedecline, and potentially as an adjunctive therapy for people with depression/mania. Across studies, LDL wasreported to be safe.Conclusions: Despite the paucity and heterogeneity of studies, LDL’s apparent pro-cognitive effects and positivesafety profile open promising avenues in the fields of neurodegeneration, and augmentation in affective disor-ders. We urge future examinations of LDL’s potential to prevent cognitive/affective syndromes

AB - Background: Lithium is widely evidenced for its neuropsychiatric benefits. Advantages of ‘sub-therapeutic’ dosesare increasingly being reported, which is apposite given enduring concerns around adverse effects of ‘thera-peutic’ doses. We aimed to synthesise all available evidence from interventional studies investigating low-doselithium (LDL) across neuropsychiatric outcomes.Methods: Electronic databases were systematically searched to include studies where a group of adult humanswere treated with LDL (~serum level ≤0.6 mmol/L), where data describing a neuropsychiatric outcome werereported either before and after treatment, and/or between lithium and a comparator.Results: 18 articles were examined and grouped according to outcome domain (cognition, depression, mania, andrelated constructs e.g., suicidality). Significant benefits (versus placebo) were identified for attenuating cognitivedecline, and potentially as an adjunctive therapy for people with depression/mania. Across studies, LDL wasreported to be safe.Conclusions: Despite the paucity and heterogeneity of studies, LDL’s apparent pro-cognitive effects and positivesafety profile open promising avenues in the fields of neurodegeneration, and augmentation in affective disor-ders. We urge future examinations of LDL’s potential to prevent cognitive/affective syndromes

UR - http://www.scopus.com/inward/record.url?scp=85143543182&partnerID=8YFLogxK

U2 - https://doi.org/10.1016/j.neubiorev.2022.104975

DO - https://doi.org/10.1016/j.neubiorev.2022.104975

M3 - Article

SN - 0149-7634

VL - 144

JO - Neuroscience and Biobehavioral Reviews

JF - Neuroscience and Biobehavioral Reviews

M1 - 104975

ER -