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Psychiatric and physical outcomes of long-term use of lithium in older adults with bipolar disorder and major depressive disorder: A cross-sectional multicenter study

2019; Elsevier BV; Volume: 259; Linguagem: Inglês

10.1016/j.jad.2019.08.056

1573-2517

Élise Morlet, Jean-François Costemale-Lacoste, Emmanuel Poulet, Kibby McMahon, Nicolas Hoertel, Frédéric Limosin, J. Adès, Charles Alezrah, I. Amado, Gilles Amar, Oana Cella Andrei, D. Arbault, G. Archambault, G. Aurifeuille, Sarah Barrière, Céline Bera‐Potelle, Yvonne Blumenstock, H. Bardou, M. Bareil-Guérin, P. Barrau, C. Barrouillet, EMILIE BAUP, Nadine Bazin, Bruno Beaufils, Jalel Ben Ayed, M. Benoit, K. Benyacoub, T. Bichet, F. Blanadet, O. Blanc, Julien Blanc-Comiti, Didier Boussiron, A.-M. Bouysse, A Brochard, O. Brochart, B. Bucheron, Maria R. Cabot, Vincent Camus, J.-M. Chabannes, Véronique Charlot, Thomas Charpeaud, C. Clad-Mor, Céline Combes, M. Comisu, B. Cordier, F. Costi, J. P. Courcelles, M. Creixell, H Cuché, Christine-Vanessa Cuervo-Lombard, A. Dammak, David Da Rin, JB Denis, H. Denizot, Anne Deperthuis, E. Diers, S. Dirami, D. Donneau, P. Dreano, Caroline Dubertret, E. Duprat, Didier Duthoit, Christine Fernandez, P. Fonfrede, Nelly Freitas, Pierre Gasnier, J. Gauillard, F. Getten, Fabien Gierski, François Godart, Raphaël Gourévitch, Aude Grassin Delyle, J. Gremion, H. Gres, Véronique Griner, Christophe Guérin-Langlois, C. Guggiari, Olivier Guillin, H Hadaoui, Émmanuel Haffen, Cécile Hanon, Sadeq Haouzir, C. Hazif-Thomas, Anne Héron, B. Hubsch, Isabelle Jalenques, Dominique Januel, Arthur Kaladjian, JF Karnycheff, O Kebir, Marie‐Odile Krebs, C Lajugie, Marion Leboyer, Philippe Legrand, Michel Lejoyeux, Véronique Lemaire, E Leroy, D Levy-Chavagnat, A. Leydier, Chantal Liling, PM Llorca, P. Loeffel, P. Louville, Stéphane Lucas, N. Mages, M. Mahi, O. Maillet, Aude Manetti, Catherine Martelli, Paula I. Martin, M Masson, I. Maurs-Ferrer, Joëlle Mauvieux, Sarkis K. Mazmanian, Emmanuelle Mechin, Lila Mékaoui, M. Meniai, A. Metton, Alain Mihoubi, Marie‐Claude Miron, G. Mora, V Niro Adès, Philippe Nubukpo, Cécile Omnès, Stéphanie Papin, P. Paris, C. Passerieux, J. Pellerin, Julie Perlbarg, S. Perron, A. Petit, François Petitjean, Christophe Portefaix, D. Pringuey, A Radtchenko, H. Rahiou, Delphine Raucher‐Chéné, Antoine Rauzy, L. Reinheimer, Marleen Renard, Magalie René‐Martellet, CE Rengade, Philippe Reynaud, Donald A. Robin, C Rodrigues, A. Rollet, Fabien Rondepierre, B. Rousselot, S. Rubingher, Ghassen Saba, JP Salvarelli, JC Samuelian, C. Scemama-Ammar, Franck Schürhoff, J. P. Schuster, D. Sechter, Béatrice Segalas, T. Seguret, AS Seigneurie, A. Semmak, Frédéric Slama, S. Taisne, Mohammed Taresh Taleb, J. L. Terra, D. Thefenne, Eric Tran, R. Tourtauchaux, MN Vacheron, Pierre Vandel, V Vanhoucke, E. Venet, Hélène Verdoux, Annie Viala, Gilles Vidon, M T Vitré, J.L. Vurpas, C. Wagermez, Michel Walter, L. Yon, X. Zendjidjian,

Schizophrenia research and treatment

Although lithium is widely used in current practice to treat bipolar disorder (BD) and treatment-resistant major depressive disorder (MDD) among older adults, little is known about its efficacy and tolerability in this population, which is generally excluded from randomized clinical trials. The objective of this study was to evaluate the efficacy and tolerability of long-term use of lithium among older adults with BD and MDD. Data from the Cohort of individuals with Schizophrenia and mood disorders Aged 55 years or more (CSA) were used. Two groups of patients with BD and MDD were compared: those who were currently receiving lithium versus those who were not. The effects of lithium on psychiatric (i.e., depressive symptoms severity, perceived clinical severity, rates of psychiatric admissions in the past-year), geriatric (overall and cognitive functioning) and physical outcomes (i.e., rates of non-psychiatric medical comorbidities and general hospital admissions in the past-year) were evaluated. All analyses were adjusted for age, sex, duration of disorder, diagnosis, smoking status, alcohol use, and use of antipsychotics, antiepileptics or antidepressants. Among the 281 older participants with BD or MDD, 15.7% were taking lithium for a mean duration of 12.5(SD = 11.6) years. Lithium use was associated with lower intensity of depressive symptoms, reduced perceived clinical global severity and lower benzodiazepine use (all p < 0.05), without being linked to greater rates of medical comorbidities, except for hypothyroidism. Data were cross-sectional and data on lifetime history of psychotropic medications was not assessed. Our results suggest that long-term lithium use may be efficient and relatively well-tolerated in older adults with BD or treatment-resistant MDD.