ReviewDrugs & aging2014
Lithium dosing and serum concentrations across the age spectrum: from early adulthood to the tenth decade of life.
Review in Drugs & aging, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 70 citations in OpenAlex.
- Lithium Toxicity in Older Adults: a Systematic Review of Case Reports.Clinical drug investigation · 2018Pooled it
- Population Pharmacokinetic Analyses of Lithium: A Systematic Review.European journal of drug metabolism and pharmacokinetics · 2018Pooled it
- Bipolar Disorder in Older Adults: A Comprehensive Overview of Pharmacotherapy Patterns and Clinical Considerations.Drugs & aging · 2026Review
- [Lithium treatment for affective disorders in old age].Der Nervenarzt · 2024Review
- Lithium Therapy in Old Age: Recommendations from a Delphi Survey.Pharmacopsychiatry · 2023Article
- [Lithium treatment for affective disorders in old age].Zeitschrift fur Gerontologie und Geriatrie · 2023Review
- Therapeutic drug monitoring of lithium therapy at a psychiatric hospital in Namibia.The Pan African medical journal · 2023Article
- Rationale and Design of Assessing the Effectiveness of Short-Term Low-Dose Lithium Therapy in Averting Cardiac Surgery-Associated Acute Kidney Injury: A Randomized, Double Blinded, Placebo Controlled Pilot Trial.Frontiers in medicine · 2021Article
- Population Pharmacokinetics of Lithium in Young Pediatric Patients With Intellectual Disability.Frontiers in pharmacology · 2021Article
- Lithium Treatment Over the Lifespan in Bipolar Disorders.Frontiers in psychiatry · 2020Review
- Atypical Arrhythmia Associated with Lithium Therapy: When to Expect the Unexpected?Acta Cardiologica Sinica · 2019Article
- Using Lithium in Older Age Bipolar Disorder: Special Considerations.Drugs & aging · 2019Review
- Factors related to lithium blood concentrations in Chinese Han patients with bipolar disorder.Neuropsychiatric disease and treatment · 2019Article
- Less Medication Use in Inpatients With Severe Mental Illness Receiving a Multidisciplinary Lifestyle Enhancing Treatment. The MULTI Study III.Frontiers in psychiatry · 2018Article
- An observational study of 110 elderly lithium-treated patients followed up for 6 years with particular reference to renal function.International journal of bipolar disorders · 2017Article
- Lithium in late-life mania: a systematic review.Neuropsychiatric disease and treatment · 2017Review
- Acute renal and neurotoxicity in older lithium users: How can we manage and prevent these events in patients with late-life mood disorders?Journal of psychiatry & neuroscience : JPN · 2015Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
Abstract
objectivesLittle is known about how lithium should be dosed to achieve therapeutic but safe serum concentrations in older adults. In this paper, we investigate how the lithium dose-concentration ratio changes across the lifespan.
methodsThis was a cross-sectional analysis of 63 current lithium users aged 20-95 years using data from McGLIDICS (the McGill Geriatric Lithium-Induced Diabetes Insipidus Clinical Study). Participants underwent blood and urine tests, including serum lithium concentrations. Multivariate analyses were conducted to evaluate potential correlates of the lithium dose-concentration ratio.
resultsWe found that between the ages of 40-95 years, the total daily dose of lithium required to achieve a given serum concentration decreases threefold (500 vs. 1,500 mg for 1.0 mmol/L). Greater age, once-daily dosing, and lower renal function (estimated glomerular filtration rate) were independently associated with a lower lithium dose-concentration ratio.
conclusionsThe lithium dose required to achieve a given serum lithium concentration decreases threefold from middle to old age, with this trend continuing into the ninth and tenth decades of life. In order to avoid lithium toxicity in aging patients, continued serum concentration monitoring and judicious dose reduction may be required, particularly in those patients with reduced renal function.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.