SynthesisClinical drug investigation2018
Lithium Toxicity in Older Adults: a Systematic Review of Case Reports.
Synthesis in Clinical drug investigation, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
What it found
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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
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.
- Towards a Safe and Effective Lithium Therapeutic Range for Older Adults With Bipolar Disorder: An ISBD Task Force Systematic Review.Bipolar disorders · 2026Pooled it
- Lithium-Charged Gold Nanoparticles: A New Powerful Tool for Lithium Delivery and Modulation of Glycogen Synthase Kinase 3 Activity.Advanced materials (Deerfield Beach, Fla.) · 2026Article
- Article
- The importance of safe lithium plasma monitoring in older people.BJPsych bulletin · 2025Review
- Acute and reversible dyskinesias secondary to lithium toxicity: case report and literature review.BMC neurology · 2025Review
- Age-Stratified Lithium Therapeutic Ranges for Older Adults with Bipolar Disorder - from Awareness to an Action Plan.EJIFCC · 2023Article
- Lithium use in childhood and adolescence, peripartum, and old age: an umbrella review.International journal of bipolar disorders · 2023Review
- From Unipolar to Bipolar: The Diagnostic Evolution in an Elderly Man.Case reports in psychiatry · 2023Article
- Effect of age and sex on prescriptions for outpatients with bipolar disorder in the MUSUBI study: a cross‑sectional study.Annals of general psychiatry · 2022Article
- When Good Kinases Go Rogue: GSK3, p38 MAPK and CDKs as Therapeutic Targets for Alzheimer's and Huntington's Disease.International journal of molecular sciences · 2021Review
- Treatable Hyperkinetic Movement Disorders Not to Be Missed.Frontiers in neurology · 2021Review
- Lithium Treatment Over the Lifespan in Bipolar Disorders.Frontiers in psychiatry · 2020Review
- The Combination of Lithium and ACE Inhibitors: Hazardous, Critical, Possible?Clinical drug investigation · 2019Article
- Delphi survey of maintenance lithium treatment in older adults with bipolar disorder: An ISBD task force report.Bipolar disorders · 2019Article
- 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
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 2 countries.
Funding
Abstract
BACKGROUND AND
objectivesDespite concerns regarding the vulnerability of older adults to lithium toxicity, this has not been well studied. This literature review aims to characterize the nature of lithium toxicity in older adults, the doses and serum lithium levels associated with toxicity, as well as its clinical and laboratory manifestations, precipitating factors, management and outcome.
methodsA systematic 10-year search of English articles was conducted using Ovid Medline, Embase Classic + Embase, Cochrane Central Register of Controlled Trials and PsycINFO. All studies on lithium toxicity in elderly (aged ≥ 65 years) where the dose of lithium or serum lithium level was clearly described, were included.
resultsThere were no clinical trials or cohort studies found. The search identified 38 cases of lithium toxicity in older adults with a mean age of 71.4 years (SD = 5.53). Mean dose of lithium was 675.4 mg/d (SD = 200.66), and mean toxic serum concentration was 2.55 mmol/L (SD = 2.22). Manifestations varied, with neurotoxicity being the most common, followed by renal and cardiovascular toxicity. Polypharmacy (63.2%) and medical comorbidity (76.3%) were common. Intravenous hydration and hemodialysis were widely used for treatment with good effect. Most patients recovered fully, and only one patient died despite treatment.
conclusionIn published case reports, the lithium dose was higher than recommended for older adults. Polypharmacy and comorbidities appeared to be important precipitating factors of lithium toxicity. Regular monitoring of serum lithium concentrations and appropriate caution should be exercised, even when serum lithium concentrations are within reported therapeutic levels.
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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.