A Amerio1, P Ossola2, F Scagnelli3, A Odone4, M Allinovi5, A Cavalli6, J Iacopelli7, M Tonna8, C Marchesi9, S N Ghaemi10. 1. Department of Mental Health, Mental Health Service of Fidenza, Parma, Italy; Mood Disorders Program, Tufts Medical Center, Boston, MA, USA. Electronic address: andrea.amerio@studenti.unipr.it. 2. Department of Medicine and Surgery, Unit of Neuroscience, University of Parma, Parma, Italy. Electronic address: ossola.paolo@gmail.com. 3. Department of Mental Health, Mental Health Service of Fiorenzuola, Piacenza, Italy. Electronic address: scagnelli.fra@libero.it. 4. School of Medicine, Vita-Salute San Raffaele University, Milan, Italy. Electronic address: anna.odone@mail.harvard.edu. 5. Nephrology and Dialysis Unit Meyer Children's Hospital, Florence, Italy. Electronic address: marco.allinovi@gmail.com. 6. Neuroscience Centre of Excellence, Meyer Children's Hospital, Florence, Italy. Electronic address: a.cavalli@meyer.it. 7. Department of Health Sciences, A. Meyer Children's University Hospital, Florence, Italy. Electronic address: jessica.iacopelli@gmail.com. 8. Department of Medicine and Surgery, Unit of Neuroscience, University of Parma, Parma, Italy. Electronic address: mtonna@ausl.pr.it. 9. Department of Medicine and Surgery, Unit of Neuroscience, University of Parma, Parma, Italy. Electronic address: carlo.marchesi@unipr.it. 10. Mood Disorders Program, Tufts Medical Center, Boston, MA, USA; Department of Psychiatry, Tufts University Medical School, Boston, MA, USA; Novartis Institutes for Biomedical Research, Translational Medicine-Neuroscience, Cambridge, MA, USA. Electronic address: nassir.ghaemi@tufts.edu.
Abstract
INTRODUCTION: Many clinicians are reluctant to use traditional mood-stabilizing agents, especially lithium, in children and adolescents. This review examined the evidence for lithium's safety and efficacy in this population. METHODS: A systematic review was conducted on the use of lithium in children and adolescents with bipolar disorder (BD). Relevant papers published through June 30th 2018 were identified searching the electronic databases MEDLINE, Embase, PsycINFO and the Cochrane Library. RESULTS: 30 articles met inclusion criteria, including 12 randomized controlled trials (RCTs). Findings from RCTs demonstrate efficacy for acute mania in up to 50% of patients, and evidence of long-term maintenance efficacy. Lithium was generally safe, at least in the short term, with most common side effects being gastrointestinal, polyuria, or headache. Only a minority of patients experienced hypothyroidism. No cases of acute kidney injury or chronic kidney disease were reported. CONCLUSIONS: Though the available literature is mostly short-term, there is evidence that lithium monotherapy is reasonably safe and effective in children and adolescents, specifically for acute mania and for prevention of mood episodes.
INTRODUCTION: Many clinicians are reluctant to use traditional mood-stabilizing agents, especially lithium, in children and adolescents. This review examined the evidence for lithium's safety and efficacy in this population. METHODS: A systematic review was conducted on the use of lithium in children and adolescents with bipolar disorder (BD). Relevant papers published through June 30th 2018 were identified searching the electronic databases MEDLINE, Embase, PsycINFO and the Cochrane Library. RESULTS: 30 articles met inclusion criteria, including 12 randomized controlled trials (RCTs). Findings from RCTs demonstrate efficacy for acute mania in up to 50% of patients, and evidence of long-term maintenance efficacy. Lithium was generally safe, at least in the short term, with most common side effects being gastrointestinal, polyuria, or headache. Only a minority of patients experienced hypothyroidism. No cases of acute kidney injury or chronic kidney disease were reported. CONCLUSIONS: Though the available literature is mostly short-term, there is evidence that lithium monotherapy is reasonably safe and effective in children and adolescents, specifically for acute mania and for prevention of mood episodes.
Authors: Danella M Hafeman; Brian Rooks; John Merranko; Fangzi Liao; Mary Kay Gill; Tina R Goldstein; Rasim Diler; Neal Ryan; Benjamin I Goldstein; David A Axelson; Michael Strober; Martin Keller; Jeffrey Hunt; Heather Hower; Lauren M Weinstock; Shirley Yen; Boris Birmaher Journal: J Am Acad Child Adolesc Psychiatry Date: 2019-07-29 Impact factor: 8.829
Authors: Vincenza Gianfredi; Lorenzo Blandi; Stefano Cacitti; Mirko Minelli; Carlo Signorelli; Andrea Amerio; Anna Odone Journal: Int J Environ Res Public Health Date: 2020-05-25 Impact factor: 3.390