Every Reason to Continue Lithium!-View Presentation

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The symposium focused on the topic "Every Reason to Continue Lithium," chaired by Dr. Balwinder Singh, a psychiatrist at the Mayo Clinic. Speakers included Dr. Michael Gitlin, a psychiatry professor at UCLA, Dr. Lourdes Gonzales, a nephrologist from Mayo Clinic, and Dr. Vishnu Sundaresh, an endocrinologist from the University of Utah. The symposium explored lithium's roles and risks in treating mood disorders, its impact on renal and endocrine functions, and strategies for managing related health issues.<br /><br />Dr. Singh emphasized lithium's often-underappreciated therapeutic benefits in contrast to its notoriety for side effects like kidney and thyroid issues. He noted studies comparing lithium with valproate, suggesting similar chronic kidney disease risks and pointing out biases against lithium in medical literature.<br /><br />Dr. Gitlin highlighted lithium's efficacy in bipolar disorder, especially in preventing manic episodes and potentially reducing suicidality. He discussed side effects, noting the significant but manageable risks to kidney, thyroid, and parathyroid functions. He shared that while lithium use requires careful monitoring of renal functions, there's often no immediate need to discontinue its use solely based on a decline in estimated glomerular filtration rate (eGFR), except in severe cases.<br /><br />Dr. Gonzales addressed lithium's nephrotoxic potential, citing conditions like nephrogenic diabetes insipidus and chronic interstitial nephritis as consequences of long-term use. She advocated for monitoring kidney health, urging referrals to nephrologists when eGFR falls below 60.<br /><br />Dr. Sundaresh reviewed lithium’s impact on thyroid and parathyroid health, explaining mechanisms of induced hypothyroidism and recommending regular thyroid function monitoring. He clarified treatment approaches, stressing that lithium-related thyroid issues are manageable, often without requiring lithium discontinuation.<br /><br />The session concluded with an emphasis on interdisciplinary management to optimize patient outcomes while minimizing lithium's adverse effects.

Keywords

Lithium

Mood disorders

Kidney health

Thyroid function

Bipolar disorder

Renal monitoring

Endocrine impact

Nephrogenic diabetes insipidus

Chronic interstitial nephritis

Hypothyroidism

Interdisciplinary management

Therapeutic benefits

Side effects