ArticleInternational journal of bipolar disorders2021
Respiratory infections during lithium and valproate medication: a within-individual prospective study of 50,000 patients with bipolar disorder.
Article in International journal of bipolar disorders, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 3 of them syntheses that pooled it.
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Who cites it
13 citing papers in PubMed, 3 syntheses or guidelines pooled it, 22 citations in OpenAlex.
- Severe mental illness and mortality in sepsis and septic shock: a systematic review and meta-analysis.Molecular psychiatry · 2024Pooled it
- Outcomes associated with different vaccines in individuals with bipolar disorder and impact on the current COVID-19 pandemic- a systematic review.European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology · 2022Pooled it
- Association Between Mood Disorders and Risk of COVID-19 Infection, Hospitalization, and Death: A Systematic Review and Meta-analysis.JAMA psychiatry · 2021Pooled it
- Exploratory CT-Based Assessment of Emphysema Burden in Smokers with Bipolar Disorder Receiving Lithium Treatment.International journal of chronic obstructive pulmonary disease · 2026Observational
- Reduced risk of severe COVID-19 with lithium use: a large-scale comparison with valproate users and other COVID-19 patients.Frontiers in psychiatry · 2025Article
- Immunogenetics of lithium response and psychiatric phenotypes in patients with bipolar disorder.Translational psychiatry · 2024Article
- Abelson Helper Integration Site 1 haplotypes and peripheral blood expression associates with lithium response and immunomodulation in bipolar patients.Psychopharmacology · 2024Article
- Beyond "Psychotropic": Repurposing Psychiatric Drugs for COVID-19, Alzheimer's Disease, and Cancer.The Journal of clinical psychiatry · 2023Review
- Association of severe mental illness and septic shock case fatality rate in patients admitted to the intensive care unit: A national population-based cohort study.PLoS medicine · 2023Article
- Association between serum lithium level and incidence of COVID-19 infection.The British journal of psychiatry : the journal of mental science · 2022Article
- Targeting the coronavirus nucleocapsid protein through GSK-3 inhibition.Proceedings of the National Academy of Sciences of the United States of America · 2021Article
- COVID-19-Related Mortality Risk in People With Severe Mental Illness: A Systematic and Critical Review.Frontiers in psychiatry · 2021Article
- Death Associated With Coronavirus (COVID-19) Infection in Individuals With Severe Mental Disorders in Sweden During the Early Months of the Outbreak-An Exploratory Cross-Sectional Analysis of a Population-Based Register Study.Frontiers in psychiatry · 2020Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundIn vitro studies have demonstrated that lithium has antiviral properties, but evidence from human studies is scarce. Lithium is used as a mood stabilizer to treat patients with bipolar disorder. Here, the aim was to investigate the association between lithium use and the risk of respiratory infections in patients with bipolar disorder. To rule out the possibility that a potential association could be due to lithium's effect on psychiatric symptoms, we also studied the effect of valproate, which is an alternative to lithium used to prevent mood episodes in bipolar disorder.
methodWe followed 51,509 individuals diagnosed with bipolar disorder in the Swedish Patient register 2005-2013. We applied a within-individual design using stratified Cox regression to estimate the hazard ratios (HRs) of respiratory infections during treated periods compared with untreated periods.
resultsDuring follow-up, 5,760 respiratory infections were documented in the Swedish Patient Register. The incidence rate was 28% lower during lithium treatment (HR 0.73, 95% CI 0.61-0.86) and 35% higher during valproate treatment (HR 1.35, 95% CI 1.06-1.73) compared with periods off treatment.
conclusionsThis study provides real-world evidence that lithium is associated with decreased risk for respiratory infections and suggests that the repurposing potential of lithium for potential antiviral or antibacterial effects is worthy of investigation.
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