JAMA Netw Open

Lithium for bipolar disorder linked to increased risk of thyroid dysfunction, CKD

February 13, 2025

Study details: This population-based retrospective cohort study analyzed data from 2002 to 2018 in Hong Kong, focusing on patients ≥15 years of age with newly diagnosed bipolar disorder. The study compared lithium treatment with non-lithium treatments, including valproate, olanzapine, quetiapine, and risperidone.

Results: Lithium was associated with a significantly increased risk of hypothyroidism (adjusted hazard ratio [aHR], 2.00; 95% confidence interval [CI], 1.72-2.33) and chronic kidney disease (CKD) stage ≥3 (aHR, 1.35; 95% CI, 1.15-1.60) compared with non-lithium treatments. Higher lithium serum levels correlated with elevated risks of hypothyroidism, hyperthyroidism, and CKD stage ≥3. The study identified specific lithium serum level thresholds associated with these risks: >0.5028 mEq/L for hypothyroidism, >0.5034 mEq/L for hyperthyroidism, and >0.5865 mEq/L for CKD stage ≥3.

Clinical impact: The findings provide empirical evidence that can inform clinical guidelines on determining optimal lithium serum level ranges, balancing treatment efficacy and safety, and promoting personalized treatment for bipolar disorder, particularly in Asian populations.

Source:

Chan JKN, et al. (2025, February 3). JAMA Netw Open. Lithium for Bipolar Disorder and Risk of Thyroid Dysfunction and Chronic Kidney Disease. https://pubmed.ncbi.nlm.nih.gov/39932712/