ArticleBipolar disorders2019
Delphi survey of maintenance lithium treatment in older adults with bipolar disorder: An ISBD task force report.
Article in Bipolar disorders, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 3 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
35 citing papers in PubMed, 3 syntheses or guidelines pooled it, 72 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 concentration and recurrence risk during maintenance treatment of bipolar disorder: Multicenter cohort and meta-analysis.Acta psychiatrica Scandinavica · 2021Pooled it
- What is the optimal serum level for lithium in the maintenance treatment of bipolar disorder? A systematic review and recommendations from the ISBD/IGSLI Task Force on treatment with lithium.Bipolar disorders · 2019Pooled it
- Feasibility and tolerability of low-dose lithium for the treatment of agitation and abnormal motor behaviors in Frontotemporal Dementia.International review of psychiatry (Abingdon, England) · 2025Trial
- Cortical Thickness in Middle and Older Aged Adults With Bipolar Disorder Across Six International Sites.Bipolar disorders · 2026Article
- Pharmacological maintenance treatment in older age bipolar disorder.Current opinion in psychiatry · 2026Review
- Low-dose lithium, neuroprotection, and brain aging in bipolar disorder.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2026Article
- Essential Information About Chronobiology and Chronotherapy for the Optimal Care of People With Bipolar Disorders: An Expert Consensus.Bipolar disorders · 2026Article
- Bipolar Disorder in Older Adults: A Comprehensive Overview of Pharmacotherapy Patterns and Clinical Considerations.Drugs & aging · 2026Review
- Lithium's effects on serum neurofilament light in Parkinson's disease: A post hoc analysis.IBRO neuroscience reports · 2026Article
- Lithium effects on renal functioning: an expert opinion and management algorithm.International journal of bipolar disorders · 2026Article
- Perioperative Management of Lithium Therapy: Considerations and Recommendations.Bipolar disorders · 2026Article
- The spectrum of bipolar disorder in older adults.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2026Review
- Clinical practice guidelines for the management of bipolar disorder: 2025 update.Indian journal of psychiatry · 2026Article
- The importance of safe lithium plasma monitoring in older people.BJPsych bulletin · 2025Review
- Influence of Ageing on the Pharmacodynamics and Pharmacokinetics of Chronically Administered Medicines in Geriatric Patients: A Review.Clinical pharmacokinetics · 2025Review
- Outpatient Management of Bipolar Disorder in Older Adults.Current psychiatry reports · 2025Review
- Lithium: current state of the art and future directions.International journal of bipolar disorders · 2024Review
- The Syndrome of Irreversible Lithium-Effectuated Neurotoxicity: A Scoping Review.Alpha psychiatry · 2024Article
- [Lithium treatment for affective disorders in old age].Der Nervenarzt · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 6 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesDespite the growing numbers and proportion of older adults with bipolar disorder (OABD), there are very limited guidelines for the use of lithium with its double-edged potential for effectiveness and toxicity in this population. The primary aims of this Delphi survey were: (a) To determine the place of lithium among the preferred choices for maintenance treatment of OABD. (b) To provide detailed clinical guidelines for the safe and effective use of lithium in OABD.
methodsIn the face of limited evidence, the Delphi survey method was used to achieve consensus by a group of 25 experts in OABD from nine countries. An oversight committee monitored and analyzed the results of each survey and formulated more focused questions with each subsequent iteration.
resultsA 100% response rate was achieved for all three iterations of the survey. Lithium was the preferred choice for maintenance monotherapy in OABD. Serum levels of 0.4-0.8 mmol/L were recommended for ages 60-79 and serum levels of 0.4-0.7 mmol/L were recommended for ages 80 and over. Specific recommendations achieved consensus for second line monotherapy as well as for other drugs to be used in combination with lithium if necessary. Guidelines for routine monitoring of lithium in OABD were provided for laboratory investigations and clinical assessments.
conclusionsLithium remains the preferred choice for maintenance monotherapy in OABD. Laboratories should report the therapeutic range for serum levels of lithium separately for older adults.
Indexed as
Identifiers
What OpenQuestion holds
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.