Lithium treatment in bipolar adolescents

A follow-up naturalistic study

Gabriele Masi, Annarita Milone, Giulia Scrinzi, Maria Mucci, Valentina Viglione, Gabriella Bruni, Stefano Berloffa, Simone Pisano

Research output: Contribution to journalArticle

Abstract

Background: Although lithium is currently approved for the treatment of bipolar disorders in youth, long term data, are still scant. The aim of this study was to describe the safety and efficacy of lithium in referred bipolar adolescents, who were followed up at the 4th (T1) and 8th (T2) month of treatment. Methods: The design was naturalistic and retrospective, based on a clinical database, including 30 patients (18 males, mean age 14.2±2.1 years). Results: Mean blood level of lithium was 0.69±0.20 mEq/L at T1 and 0.70±0.18 mEq/L at T2. Both Clinical Global Impression-Severity (CGI-S) and Children Global Assessment Scale (C-GAS) scores improved from baseline (CGI-S 5.7±0.5, C-GAS 35.1±3.7) to T1 (CGI-S 4.2±0.70, C-GAS 46.4±6.5; P<0.001), without significant differences from T1 to T2. Thyroid-stimulating hormone significantly increased from 2.16±1.8 mU/mL at baseline to 3.9±2.7 mU/mL at T2, remaining within the normal range, without changes in T3/T4 levels; two patients needed a thyroid hormone supplementation. Creatinine blood level did not change. No cardiac symptoms and electrocardiogram QTc changes occurred. White blood cell count significantly increased from 6.93±1.68 103/mmc at baseline to 7.94±1.94 103/mmc at T2, and serum calcium significantly increased from 9.68±0.3 mg/dL at baseline to 9.97±0.29 mg/dL at T2, both remaining within the normal range; all the other electrolyte levels were stable and normal during the follow-up. The treatment with lithium was well tolerated, probably due to the relatively low lithium blood levels. Gastrointestinal symptoms (16.7%), sedation (9.7%) and tremor (6.4%) were the most frequently reported side effects. Conclusion: Lithium was effective and safe in adolescent bipolar patients followed-up for eight months.

Original languageEnglish
Pages (from-to)2749-2753
Number of pages5
JournalNeuropsychiatric Disease and Treatment
Volume14
DOIs
Publication statusPublished - Jan 1 2018

Fingerprint

Lithium
Reference Values
Therapeutics
Tremor
Thyrotropin
Thyroid Hormones
Leukocyte Count
Bipolar Disorder
Electrolytes
Creatinine
Electrocardiography
Databases
Calcium
Safety
Serum

Keywords

  • Adolescents
  • Bipolar disorder
  • Lithium
  • Safety

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

Cite this

Lithium treatment in bipolar adolescents : A follow-up naturalistic study. / Masi, Gabriele; Milone, Annarita; Scrinzi, Giulia; Mucci, Maria; Viglione, Valentina; Bruni, Gabriella; Berloffa, Stefano; Pisano, Simone.

In: Neuropsychiatric Disease and Treatment, Vol. 14, 01.01.2018, p. 2749-2753.

Research output: Contribution to journalArticle

@article{195ad3411cd54132ba4d3ccf82015b3d,
title = "Lithium treatment in bipolar adolescents: A follow-up naturalistic study",
abstract = "Background: Although lithium is currently approved for the treatment of bipolar disorders in youth, long term data, are still scant. The aim of this study was to describe the safety and efficacy of lithium in referred bipolar adolescents, who were followed up at the 4th (T1) and 8th (T2) month of treatment. Methods: The design was naturalistic and retrospective, based on a clinical database, including 30 patients (18 males, mean age 14.2±2.1 years). Results: Mean blood level of lithium was 0.69±0.20 mEq/L at T1 and 0.70±0.18 mEq/L at T2. Both Clinical Global Impression-Severity (CGI-S) and Children Global Assessment Scale (C-GAS) scores improved from baseline (CGI-S 5.7±0.5, C-GAS 35.1±3.7) to T1 (CGI-S 4.2±0.70, C-GAS 46.4±6.5; P<0.001), without significant differences from T1 to T2. Thyroid-stimulating hormone significantly increased from 2.16±1.8 mU/mL at baseline to 3.9±2.7 mU/mL at T2, remaining within the normal range, without changes in T3/T4 levels; two patients needed a thyroid hormone supplementation. Creatinine blood level did not change. No cardiac symptoms and electrocardiogram QTc changes occurred. White blood cell count significantly increased from 6.93±1.68 103/mmc at baseline to 7.94±1.94 103/mmc at T2, and serum calcium significantly increased from 9.68±0.3 mg/dL at baseline to 9.97±0.29 mg/dL at T2, both remaining within the normal range; all the other electrolyte levels were stable and normal during the follow-up. The treatment with lithium was well tolerated, probably due to the relatively low lithium blood levels. Gastrointestinal symptoms (16.7{\%}), sedation (9.7{\%}) and tremor (6.4{\%}) were the most frequently reported side effects. Conclusion: Lithium was effective and safe in adolescent bipolar patients followed-up for eight months.",
keywords = "Adolescents, Bipolar disorder, Lithium, Safety",
author = "Gabriele Masi and Annarita Milone and Giulia Scrinzi and Maria Mucci and Valentina Viglione and Gabriella Bruni and Stefano Berloffa and Simone Pisano",
year = "2018",
month = "1",
day = "1",
doi = "10.2147/NDT.S172654",
language = "English",
volume = "14",
pages = "2749--2753",
journal = "Neuropsychiatric Disease and Treatment",
issn = "1176-6328",
publisher = "Dove Medical Press Ltd.",

}

TY - JOUR

T1 - Lithium treatment in bipolar adolescents

T2 - A follow-up naturalistic study

AU - Masi, Gabriele

AU - Milone, Annarita

AU - Scrinzi, Giulia

AU - Mucci, Maria

AU - Viglione, Valentina

AU - Bruni, Gabriella

AU - Berloffa, Stefano

AU - Pisano, Simone

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Although lithium is currently approved for the treatment of bipolar disorders in youth, long term data, are still scant. The aim of this study was to describe the safety and efficacy of lithium in referred bipolar adolescents, who were followed up at the 4th (T1) and 8th (T2) month of treatment. Methods: The design was naturalistic and retrospective, based on a clinical database, including 30 patients (18 males, mean age 14.2±2.1 years). Results: Mean blood level of lithium was 0.69±0.20 mEq/L at T1 and 0.70±0.18 mEq/L at T2. Both Clinical Global Impression-Severity (CGI-S) and Children Global Assessment Scale (C-GAS) scores improved from baseline (CGI-S 5.7±0.5, C-GAS 35.1±3.7) to T1 (CGI-S 4.2±0.70, C-GAS 46.4±6.5; P<0.001), without significant differences from T1 to T2. Thyroid-stimulating hormone significantly increased from 2.16±1.8 mU/mL at baseline to 3.9±2.7 mU/mL at T2, remaining within the normal range, without changes in T3/T4 levels; two patients needed a thyroid hormone supplementation. Creatinine blood level did not change. No cardiac symptoms and electrocardiogram QTc changes occurred. White blood cell count significantly increased from 6.93±1.68 103/mmc at baseline to 7.94±1.94 103/mmc at T2, and serum calcium significantly increased from 9.68±0.3 mg/dL at baseline to 9.97±0.29 mg/dL at T2, both remaining within the normal range; all the other electrolyte levels were stable and normal during the follow-up. The treatment with lithium was well tolerated, probably due to the relatively low lithium blood levels. Gastrointestinal symptoms (16.7%), sedation (9.7%) and tremor (6.4%) were the most frequently reported side effects. Conclusion: Lithium was effective and safe in adolescent bipolar patients followed-up for eight months.

AB - Background: Although lithium is currently approved for the treatment of bipolar disorders in youth, long term data, are still scant. The aim of this study was to describe the safety and efficacy of lithium in referred bipolar adolescents, who were followed up at the 4th (T1) and 8th (T2) month of treatment. Methods: The design was naturalistic and retrospective, based on a clinical database, including 30 patients (18 males, mean age 14.2±2.1 years). Results: Mean blood level of lithium was 0.69±0.20 mEq/L at T1 and 0.70±0.18 mEq/L at T2. Both Clinical Global Impression-Severity (CGI-S) and Children Global Assessment Scale (C-GAS) scores improved from baseline (CGI-S 5.7±0.5, C-GAS 35.1±3.7) to T1 (CGI-S 4.2±0.70, C-GAS 46.4±6.5; P<0.001), without significant differences from T1 to T2. Thyroid-stimulating hormone significantly increased from 2.16±1.8 mU/mL at baseline to 3.9±2.7 mU/mL at T2, remaining within the normal range, without changes in T3/T4 levels; two patients needed a thyroid hormone supplementation. Creatinine blood level did not change. No cardiac symptoms and electrocardiogram QTc changes occurred. White blood cell count significantly increased from 6.93±1.68 103/mmc at baseline to 7.94±1.94 103/mmc at T2, and serum calcium significantly increased from 9.68±0.3 mg/dL at baseline to 9.97±0.29 mg/dL at T2, both remaining within the normal range; all the other electrolyte levels were stable and normal during the follow-up. The treatment with lithium was well tolerated, probably due to the relatively low lithium blood levels. Gastrointestinal symptoms (16.7%), sedation (9.7%) and tremor (6.4%) were the most frequently reported side effects. Conclusion: Lithium was effective and safe in adolescent bipolar patients followed-up for eight months.

KW - Adolescents

KW - Bipolar disorder

KW - Lithium

KW - Safety

UR - http://www.scopus.com/inward/record.url?scp=85057567760&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85057567760&partnerID=8YFLogxK

U2 - 10.2147/NDT.S172654

DO - 10.2147/NDT.S172654

M3 - Article

VL - 14

SP - 2749

EP - 2753

JO - Neuropsychiatric Disease and Treatment

JF - Neuropsychiatric Disease and Treatment

SN - 1176-6328

ER -