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Lithium in Bipolar Disorder: Optimizing Therapy Using Prolonged-Release Formulations
Lithium has been a gold standard in the treatment of bipolar disorder (BD) for several decades. Despite a general reduction in the use of lithium over the past several years, it is effective in the management of both manic and depressive episodes in BD and continues to be recommended as a first-line...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5114200/ https://www.ncbi.nlm.nih.gov/pubmed/27770296 http://dx.doi.org/10.1007/s40268-016-0139-7 |
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author | Girardi, Paolo Brugnoli, Roberto Manfredi, Giovanni Sani, Gabriele |
author_facet | Girardi, Paolo Brugnoli, Roberto Manfredi, Giovanni Sani, Gabriele |
author_sort | Girardi, Paolo |
collection | PubMed |
description | Lithium has been a gold standard in the treatment of bipolar disorder (BD) for several decades. Despite a general reduction in the use of lithium over the past several years, it is effective in the management of both manic and depressive episodes in BD and continues to be recommended as a first-line mood stabilizer. This review provides an overview of the pharmacology of lithium and highlights its clinical profile in the management of BD, focusing on the potential advantages of prolonged-release (PR) versus immediate-release (IR) formulations of lithium. A literature search using PubMed was performed to identify articles describing IR and PR lithium in BD using specific search terms like ‘lithium’, ‘prolonged-release’, ‘sustained-release’, ‘extended-release’, ‘bipolar disorder’, ‘adherence’ and ‘compliance’. Relevant pharmacodynamic and pharmacokinetic data were also included. Several clinical trials suggested that lithium is effective in the treatment of acute mania and prophylaxis of BD and reduces the risk of suicide in patients with BD; it may also be used in combination with other drugs in the treatment of bipolar depression. Treatment with lithium must be monitored to avoid lithium-associated toxicity. The prolonged PR formulation of lithium has several advantages including consistent serum lithium concentrations, fewer adverse events and improved adherence to therapy. Although direct comparative studies between PR and IR formulations of lithium are primarily limited to pharmacokinetic studies, PR formulation of lithium provides potential advantages over IR formulation and can be effectively used in the management of BD with lesser adverse events. |
format | Online Article Text |
id | pubmed-5114200 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-51142002016-11-29 Lithium in Bipolar Disorder: Optimizing Therapy Using Prolonged-Release Formulations Girardi, Paolo Brugnoli, Roberto Manfredi, Giovanni Sani, Gabriele Drugs R D Review Article Lithium has been a gold standard in the treatment of bipolar disorder (BD) for several decades. Despite a general reduction in the use of lithium over the past several years, it is effective in the management of both manic and depressive episodes in BD and continues to be recommended as a first-line mood stabilizer. This review provides an overview of the pharmacology of lithium and highlights its clinical profile in the management of BD, focusing on the potential advantages of prolonged-release (PR) versus immediate-release (IR) formulations of lithium. A literature search using PubMed was performed to identify articles describing IR and PR lithium in BD using specific search terms like ‘lithium’, ‘prolonged-release’, ‘sustained-release’, ‘extended-release’, ‘bipolar disorder’, ‘adherence’ and ‘compliance’. Relevant pharmacodynamic and pharmacokinetic data were also included. Several clinical trials suggested that lithium is effective in the treatment of acute mania and prophylaxis of BD and reduces the risk of suicide in patients with BD; it may also be used in combination with other drugs in the treatment of bipolar depression. Treatment with lithium must be monitored to avoid lithium-associated toxicity. The prolonged PR formulation of lithium has several advantages including consistent serum lithium concentrations, fewer adverse events and improved adherence to therapy. Although direct comparative studies between PR and IR formulations of lithium are primarily limited to pharmacokinetic studies, PR formulation of lithium provides potential advantages over IR formulation and can be effectively used in the management of BD with lesser adverse events. Springer International Publishing 2016-10-21 2016-12 /pmc/articles/PMC5114200/ /pubmed/27770296 http://dx.doi.org/10.1007/s40268-016-0139-7 Text en © The Author(s) 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Review Article Girardi, Paolo Brugnoli, Roberto Manfredi, Giovanni Sani, Gabriele Lithium in Bipolar Disorder: Optimizing Therapy Using Prolonged-Release Formulations |
title | Lithium in Bipolar Disorder: Optimizing Therapy Using Prolonged-Release Formulations |
title_full | Lithium in Bipolar Disorder: Optimizing Therapy Using Prolonged-Release Formulations |
title_fullStr | Lithium in Bipolar Disorder: Optimizing Therapy Using Prolonged-Release Formulations |
title_full_unstemmed | Lithium in Bipolar Disorder: Optimizing Therapy Using Prolonged-Release Formulations |
title_short | Lithium in Bipolar Disorder: Optimizing Therapy Using Prolonged-Release Formulations |
title_sort | lithium in bipolar disorder: optimizing therapy using prolonged-release formulations |
topic | Review Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5114200/ https://www.ncbi.nlm.nih.gov/pubmed/27770296 http://dx.doi.org/10.1007/s40268-016-0139-7 |
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