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Journal: Proteomic analysis of urinary exosomes from patients with lithium-induced nephrogenic diabetes insipidus. (Pubmed Central) - May 14, 2022
A double-blind, randomized, placebo-controlled pilot trial of atorvastatin for nephrogenic diabetes insipidus in lithium users...In addition, urine from random healthy controls (n=6) were collected. Urine samples from the rodent study and human study were subjected to ultracentrifugation for exosome isolation and will be further processed for mass spectrometry analysis (MS/MS).
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Journal: Lithium-associated nephrotoxicity: role of GDF15-mediated collecting duct cells proliferation. (Pubmed Central) - May 14, 2022
In conclusion, these results suggest a direct relationship between lithium-induced proliferation signals, collecting duct cell dysfunction and GDF15 expression. Further investigation is needed to determine if GDF15 signaling might represent a therapeutic target in Li+-induced nephrotoxicity.
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Journal: Perioperative management of lithium in the patient undergoing pituitary surgery: a case report. (Pubmed Central) - May 10, 2022
We present the case of a 65-year old man admitted for pituitary surgery complicated by post-operative difficult fluid management and subsequent lithium toxicity. We highlight this rare situation and the need to be vigilant in the peri-operative period with any patients on lithium who undergo pituitary surgery.
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Review, Journal: Integrated pathophysiology of schizophrenia, major depression, and bipolar disorder as monoamine axon disorder. (Pubmed Central) - May 7, 2022
Together, based on accumulating data from animal and human studies, the pathophysiology of schizophrenia, major depression, and bipolar disorder is summarized as follows: The degeneration of monoamine axons is associated with the negative and cognitive symptoms of schizophrenia, major and bipolar depression, while hyper-regeneration/sprouting of monoamine axons underlies the positive symptoms of schizophrenia and bipolar mania. The integrated understanding of schizophrenia, major depression, and bipolar disorder as monoamine axon disorder will open the door to the development of new diagnosis and treatment methods for major mental illnesses as well as early-stage Parkinson's disease.
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Journal: Association of Lithium Treatment With the Risk of Osteoporosis in Patients With Bipolar Disorder. (Pubmed Central) - May 7, 2022
In this study, bipolar disorder was associated with an increase in risk of osteoporosis, and lithium treatment was associated with a decrease in risk of osteoporosis. These findings suggest that bone health should be a priority in the clinical management of bipolar disorder and that the potential bone-protective properties of lithium should be subjected to further study, both in the context of bipolar disorder and in osteoporosis.
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Preclinical, Journal: Phosphorylation of PI3K/Akt at Thr308, but not MAPK kinase, mediates lithium-induced neuroprotection against cerebral ischemia in mice. (Pubmed Central) - May 6, 2022
To distinguish whether neuroprotective effects of lithium are modulated by PI3K/Akt or MEK, we sequentially blocked these pathways and demonstrated that the neuroprotective activity of lithium persisted during MEK/ERK inhibition, whereas PI3K/Akt inhibition abolished neuroprotection. Collectively, we demonstrated lithium exerts its post-stroke neuroprotective activity via the PI3K/Akt pathway, specifically via Akt phosphorylation at Thr308, but not via MEK/ERK.
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Journal: CADPS functional mutations in patients with bipolar disorder increase the sensitivity to stress. (Pubmed Central) - May 6, 2022
Furthermore, hyperactivity observed in mutant animals was rescued by the mood-stabilizing drug lithium. Overall, our results suggest that dysfunction in calcium-dependent vesicular exocytosis may increase the sensitivity to environmental stressors enhancing the risk of developing bipolar disorder.
- |||||||||| lamotrigine liquid oral suspension / OWP Pharma
Clinical guideline, Journal: Borderline Personality Disorder: Clinical Guidelines for Treatment. (Pubmed Central) - May 6, 2022
Where the history suggests a genetic link to bipolar disorder, a mood stabilizer such as lithium or lamotrigine, even in modest doses, may be particularly beneficial, more so than conventional antidepressants...As for the psychotherapeutic component, the patient's cognitive style and capacity for introspection will help determine whether a primarily expressive (psychoanalytically oriented) technique is preferable or a primarily cognitive-behavioral technique. Flexibility is necessary, since during emotional crises, supportive and limit-setting interventions will be needed, along with psychotropic medications, and where necessary, programs to help combat substance abuse (which is common among patients with BPD).
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Can We Predict Lithium Response Status in Bipolar Disorder Using Total Brain Volumetric parameters? () - May 6, 2022 - Abstract #SOBP2022SOBP_1036;
Taking the above results together, we conclude that baicalin can promote the proliferation and development of PC-12 cells by regulating GSK3β pathway, so as to reverse the depressive-like pathological changes induced by corticosterone. Total brain volume parameters did not demonstrate relation to lithium response, but regional brain volume alterations can be explored further.
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Association of Wnt7a Pathways in Distinct Human Amygdala Cell Populations and Affective Symptoms in Bipolar Disease (Churchill) - May 6, 2022 - Abstract #SOBP2022SOBP_99;
While the current study cannot rule out associations of smaller effect size, present findings suggest that leading mood-stabilizing medications are not associated with frank cognitive impairments in youth with BD. These data indicate a Wnt-subtype specific regulation in distinct neurons in theamygdala, including GSK3β, R-spo2β, and DKK3 that are associated to BD.
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Association between the Epigenetic Lifespan Predictor Grimage and History of Suicide Attempt in Bipolar Disorder (Princess Ballroom I) - May 6, 2022 - Abstract #ASCP2022ASCP_49;
Funding: This study was funded by the National Institute of Mental Health (NIMH, K01MH121580-01A1) and the Faillace Department of Psychiatry and Behavioral Sciences, UTHealth. Learning Objectives Discuss epigenetic mechanisms of accelerated aging in patients with bipolar disorder with lifetime history of suicide attempt; Discuss how accelerated aging in bipolar disorder may be associated with high morbidity and early mortality in these patients.
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Real-World Clinical Practice among Patients with Bipolar Disorder and Chronic Kidney Disease on Long-Term Lithium Therapy. (Princess Ballroom F) - May 6, 2022 - Abstract #ASCP2022ASCP_35;
Further studies with a larger sample size are required to understand the intricacies of medication changes in this BD phenotype. Learning Objectives To investigate the real-world clinical practice among patients with bipolar disorders and chronic kidney disease (CKD) on long-term lithium therapy To identify the differences in clinical characteristics, pharmacotherapeutic changes, and outcomes among bipolar disorder patients with CKD who continued lithium vs those who discontinued lithium after CKD diagnoses in a 2-year mirror-image study design.
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Hypercalcemia Associated With Short-Term Lithium Treatment in a Patient With Bipolar I Disorder () - May 5, 2022 - Abstract #APA2022APA_939;
Lithium was continued for 3 more days, when she became delirious with bradycardia in the setting of recently prescribed gabapentin for pain and metoprolol for HTN...In this report, we review the literature of lithium associated with hypercalcemia. This case highlights the need to remain aware of potential metabolic side effects of mood stabilizing medications and to carefully differentiate presenting symptoms of a mental illness such as bipolar disorder from the fluctuating cognitive symptoms of acute delirium
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Can Lithium Reduce the Risk of Osteoporosis? A Population-Based Study of 22,912 Patients With Bipolar Disorder () - May 5, 2022 - Abstract #APA2022APA_846;
This case highlights the need to remain aware of potential metabolic side effects of mood stabilizing medications and to carefully differentiate presenting symptoms of a mental illness such as bipolar disorder from the fluctuating cognitive symptoms of acute delirium This is the first longitudinal study to show that treatment with lithium is associated with reduced risk of osteoporosis.
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“It’s a Girl!”: Improving Pregnancy Testing Frequency in the Emergent Psychiatric Setting () - May 5, 2022 - Abstract #APA2022APA_791;
Testing patients in reproductive age for pregnancy allows clinicians and patients to make data-informed decisions regarding the use of psychotropic medications. We will review the effect that our interventions had on the frequency of pregnancy testing in the emergency setting and accordingly assess further interventions required and make recommendations for other clinicians.
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Too Much Too Fast: Challenges in the Initiation and Titration of Lithium in Patients With Bipolar Disorder () - May 5, 2022 - Abstract #APA2022APA_700;
The prior medications included lamotrigine (rash), valproic acid (over-sedation), quetiapine (over-sedation), and multiple serotonin-reuptake inhibitors (“weird sensations”)...However, a slow titration of lithium with once-daily dosing at nighttime may be preferred in the outpatient setting (3). This titration strategy may not only limit side effects such as nausea and polyuria, but also minimize the risk of kidney injury and improve medication adherence (4).
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Racial and Gender Disparities in the Diagnosis and Treatment of Bipolar Disorder () - May 5, 2022 - Abstract #APA2022APA_617;
Black patients with bipolar disorder, in comparison to White patients, had significantly less utilization of lithium, lamotrigine, and antidepressants, but greater utilization of haloperidol or other first generation antipsychotics...These disparities have real world clinical implications with less utilization of gold standard mood stabilization treatment. Further community-guided research to better understand the origins of these disparities and clinical trials to evaluate non-antipsychotic mood stabilization treatment for bipolar disorder across populations is warranted.
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Lithium-Induced Hypercalcemia Presenting as Catatonia in a Patient With Schizoaffective Disorder () - May 5, 2022 - Abstract #APA2022APA_534;
This case illustrates the importance of recognizing rare clinical presentations of hypercalcemia in patients on chronic lithium therapy. Because the neuropsychiatric manifestations of hypercalcemia are so broad, it is important to understand this phenomenon and be able to distinguish it from primary psychiatric disturbances (8).
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Lithium and Its Side Effects, a Case Study () - May 5, 2022 - Abstract #APA2022APA_533;
He was initially started on Lithium over 30 years ago after experiencing an episode of paradoxical increased agitation when he took one dose of Ativan...At the time of this report, this patient has begun tapering off of Lithium and on an upward titration of Lamictal, off label, for the target symptom of irritability. Treatment goals for this patient include complete discontinuation of Lithium to avoid any further renal insult, regaining of his ability to concentrate his urine with resolution of Lithium induced nephrogenic diabetes insipidus, normalization of parathyroid stimulating hormone and secondarily normalization of calcium metabolism.
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COVID-19 Creating a “Long-Haul” Hospitalization for Bipolar Disorder () - May 5, 2022 - Abstract #APA2022APA_422;
Additionally, this patient was treated with antipsychotic medication that is not known to have a significant anti-inflammatory effect. This may represent further support for reported success with psychiatric medications that also have anti-inflammatory properties through the sigma receptor such as: Fluvoxamine and Haloperidol.
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A Difficult Pediatric Case of Treatment-Resistant Bipolar Disorder: A Case Report () - May 5, 2022 - Abstract #APA2022APA_332;
The patient showed a good response to this regimen and was discharged with no recurrence of symptoms for 3 months of outpatient follow-up. In this poster we discuss the challenges of treating pediatric bipolar disorder and summarize recent guidelines that provide a stepwise approach for its management.
- |||||||||| Rituxan (rituximab) / Biogen, Zenyaku Kogyo, Roche
A Case of Chronic Hashimoto Encephalopathy With Delayed Treatment Due to Psychiatric Symptoms () - May 5, 2022 - Abstract #APA2022APA_319;
However, over the next several months she presented several times with worsening manic and psychotic symptoms including elevated mood, flight of ideas, increased speech rate, decreased need for sleep, excessive spending, grandiose delusions, and paranoia and was diagnosed with bipolar disorder and started on lithium, olanzapine, and lorazepam though ultimately only improved after index course of electro-convulsive treatment (ECT)... This case highlights the importance of proper diagnosis and treatment of chronic Hashimoto encephalopathy despite underlying psychiatric symptoms.
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Clinical, Journal: Efficacy and Safety of Lithium Treatment in SARS-CoV-2 Infected Patients. (Pubmed Central) - May 3, 2022
We showed that lithium was able to reduce the number of days of hospital and intensive care unit admission as well as the risk of death, reduces inflammatory cytokine levels by preventing cytokine storms, and also reduced the long COVID syndromes. We propose that lithium carbonate can be used to reduce the severity of COVID-19.
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Journal: Symptom Overlap of Acute Mountain Sickness and Lithium Toxicity: A Case Report. (Pubmed Central) - Apr 29, 2022
We advise individualized testing of athletes' lithium levels in response to exercise and altitude, and we recommend physicians counsel their patients on ways to maintain therapeutic lithium levels during their athletic pursuits, including the importance of hydration and avoidance of nonsteroidal anti-inflammatory drugs. Further research is needed on lithium pharmacokinetics in conditions of exercise and altitude exposure.
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Mitigating Maternal Melancholy (Rooms 265-268 , Ernest N. Morial Convention Center) - Apr 26, 2022 - Abstract #APA2022APA_245;
The treatment courses of pregnant women with unipolar depression and bipolar disorder will be described to illustrate strategies for management based on research findings for the drug management of psychotropic medication during pregnancy. Data from the author’s recent study of the pharmacokinetics and pharmacogenomics of SSRI will be included to support management strategies and treatment recommendations.
- |||||||||| ebselen (SPI-1005) / Sound Pharma
Review, Journal: The Potential Use of Ebselen in Treatment-Resistant Depression. (Pubmed Central) - Apr 24, 2022
It will also be important to ascertain whether ebselen is able to lower impulsivity and suicidal behaviour in clinical populations. The objective of this review is to summarise the developmental history, pre-clinical and clinical psychopharmacological properties of ebselen in psychiatric disorders and its potential application as a treatment for TRD.
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Retrospective data, Journal: Long-Term Effects of Lithium Use on Children and Adolescents: A Retrospective Study from Turkey. (Pubmed Central) - Apr 22, 2022
No patients had serum creatinine levels exceeding the normal reference values. Our study suggests that lithium is a generally safe and tolerable agent for children and adolescents with BD and non-BD; however, close monitoring of thyroid functions particularly in patients with a higher basal TSH level and longer duration of lithium use is important.
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Journal: Lithium as a first-step option for acute phase pharmacotherapy of bipolar depression. (Pubmed Central) - Apr 20, 2022
The acute phase pharmacotherapy of a depressive episode in patients with bipolar disorder, in the following referred to as treatment of bipolar depression, is especially challenging. The evidence for lithium as a treatment of bipolar depression is limited and conflicting (2), and therefore the positioning of this drug for the treatment of bipolar depression in upcoming guidelines is of particular interest.
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