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The Carlat Psychiatry Podcast

Lithium: 12 Updates from 2023

Jan 1, 2024
The podcast discusses the latest research on lithium, including its efficacy in treating bipolar disorder and unipolar depression, its impact on suicide rates and psychosocial functioning, and its role in augmenting antidepressants. It also explores the side effects and patient experiences of lithium compared to quatypine, the effectiveness of different lithium treatments for tremor in bipolar disorder, and renal risk factors associated with lithium use.
22:06

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Quick takeaways

  • Lithium is effective in reducing suicide attempts, improving long-term functioning, and lowering hospitalization rates for bipolar and unipolar depression, challenging the perception that antipsychotics have better evidence in treating bipolar depression.
  • Lithium consistently emerges as a favorable choice for augmentation therapy in the treatment of resistant depression, along with intravenous ketamine, based on a network meta-analysis of trials comparing augmentation strategies.

Deep dives

Lithium's superior efficacy in the early course of bipolar disorder

The International Society of Bipolar Disorders released guidelines suggesting that lithium use in the early stages of bipolar disorder lowers the risk of recurrence compared to other mood stabilizers. Observational studies have also shown that lithium is effective in reducing suicide attempts, improving long-term functioning, and lowering hospitalization rates for bipolar and unipolar depression. These findings challenge the perception that antipsychotics have better evidence in treating bipolar depression than lithium.

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