Oppfølging av pasienter som bruker litium

Effekten er godt dokumentert, men midlet kan gi alvorlige bivirkninger og interaksjoner med andre legemidler. Litium har et smalt terapeutisk område og intoksikasjoner kan forekomme ved vanlige/lave doser. (Tidsskr Nor Legeforen 2008; 128:1410-2 (12.6.2008))

DrugLabel lithium carbonate (Lithium Carbonate) tablet, extended release [Boehringer Ingelheim Roxane Laboratories] (fda.gov)

- Litium i det lange løp: Giftighet mht. nyre- og skjolbruskkjertel

Lithium in the Long Run: Renal and Thyroid Toxicity
NEJM 2015 (June 15, 2015)
Peter Roy-Byrne, MD reviewing Shine B et al. Lancet 2015 May 20.
Lithium is a first-line mood stabilizer but requires delicate dose adjustments and vigorous monitoring for renal, thyroid, and parathyroid effects.

Lithium has renal, thyroid, and parathyroid effects, which are well documented but mostly in short-term studies. Using data from a laboratory information system in the U.K. between 1985 and 2014, researchers compared creatinine, thyroid-stimulating hormone (TSH), and calcium values in 2795 patients with at least two lithium levels and in 689,228 patients not taking lithium (median follow-up, 3 years).

After the presence of diabetes was controlled for, lithium was associated with elevated risks of stage 3 kidney disease (glomerular filtration rate, <60 mL/min), hypothyroidism (TSH, >5.5 mU/L), and elevated total (but not ionized) calcium. Young women were the group at greatest risk for renal and thyroid effects. Overall, adverse effects were greater with higher-than-median lithium levels and shorter length of treatment. (…)

(Anm: Lithiumforgiftning. Lægemiddelstyrelsen har i den senere tid modtaget flere indberetninger om lithiumforgiftning. Indberetningerne har omhandlet patienter i behandling med lithium, der samtidig var dehydreret eller havde andre risikofaktorer. Lithiums terapeutiske interval er snævert, og begyndende toksisk påvirkning forekommer ved serumkoncentrationer over 1,2 mmol/L. (NYT OM BIVIRKNINGER NR. 3 • ÅRGANG 7 • MARTS 2016).)

(Anm: Mortality associated with lithium and valproate treatment of US Veterans Health Administration patients with mental disorders. The British Journal of Psychiatry  2015;207 (1):55-63 (Jul 2015).)

(Anm: Lithium in drinking water and suicide mortality: interplay with lithium prescriptions. The British Journal of Psychiatry  2015;207(1): 64-71 (Jul 2015).)

- Dokumenter reiser nye bekymringer om litiumstudie på barn. (- Psykiater ved University of Illinois i Chicago innrullerte sine unge sønner som kontrollpersoner i kriserammet studie.) (- Hun fikk utbetalt rundt 200 000 dollar per år, pluss bonuser. I tillegg til hennes forskning behandlet hun og førte tilsyn med omsorgen for tusenvis av barn, som inkluderte 1 200 i fem år etter sin forskning..)

 (Anm: Documents Raise New Concerns About Lithium Study on Children. Prominent University of Illinois at Chicago psychiatrist enrolled her young sons as healthy control subjects in troubled study. Newly obtained records raise additional concerns about the research and oversight of Dr. Mani Pavuluri, a star pediatric psychiatrist at the University of Illinois at Chicago whose clinical trial studying the effects of the powerful drug lithium on children was shuttered for misconduct. ProPublica Illinois has learned: - Parents of at least eight children who participated in Pavuluri’s trials contacted UIC after learning she had violated research rules, a larger number than the university previously disclosed — though UIC officials insist only one of the queries was a complaint. - Pavuluri enrolled 101 children and teens diagnosed with bipolar disorder in the lithium study before it was halted when one of the young subjects became ill. UIC officials previously declined to answer questions about how many children participated in the government-funded study, citing an ongoing federal investigation. - The psychiatrist’s two young sons were among 132 children and teens who participated as healthy control subjects, a violation of university protocol and generally accepted research practices. (…) She was paid about $200,000 a year, plus bonuses. In addition to her research, she treated and oversaw the care of thousands of children, including 1,200 in the five years after her research. (propublica.org 3.7.2018).)

(Anm: Habilitet (integritet) (mintankesmie.no).)

- Et universitet gikk langt for å blokkere offentliggjøring av informasjon om et forsøk (studie) som feilet.

(Anm: A university went to great lengths to block the release of information about a trial gone wrong. A reporter fought them and revealed the truth. Here’s a story that shows the lengths a public university — The University of Illinois at Chicago — went to block the release of information about a child psychiatry trial gone wrong, and how a reporter — Jodi S. Cohen of ProPublica — fought them effectively at every turn to reveal the truth. Earlier this year, ProPublica “revealed that the National Institute of Mental Health ordered the university to repay $3.1 million in grant money it had received to fund [Mani] Pavuluri’s study.” This kind of clawback is very, very rare.  (retractionwatch.com 4.7.2018).)

(Anm: Forskning og ressurser (mintankesmie.no).)

- Økt oksidativt stress i mitokondriene isolert fra lymfocytter ved bipolar lidelse hos pasienter under depressive episoder. (- Til slutt konkluderer våre resultater at mitokondriell oksidativ stress og mitokondriell complex II dysfunksjon spiller viktige roller i depressiv fase av BD.)

(Anm: Increased oxidative stress in the mitochondria isolated from lymphocytes of bipolar disorder patients during depressive episodes. Abstract The present study aims to investigate the oxidative stress parameters in isolated mitochondria, as well as looking at mitochondrial complex activity in patients with Bipolar Disorder (BD) during depressive or euthymic episodes. This study evaluated the levels of mitochondrial complex (I, II, II-III and IV) activity in lymphocytes from BD patients. (…) In conclusion, our results suggest that mitochondrial oxidative stress and mitochondrial complex II dysfunction play important roles in the depressive phase of BD. Psychiatry Res. 2018 Apr 4;264:192-201.)

(Anm: Lithium treatment and risk for dementia in adults with bipolar disorder: population-based cohort study. The British Journal of Psychiatry. 2015;207(1): 46-51 (Jul 2015).)

- Mitokondriell dysfunksjon ligger bak kognitive defekter som et resultat av nevral stamcelleutarmning og nedsatt neurogenese.

(Anm: Mitokondriell dysfunksjon ligger bak kognitive defekter som et resultat av nevral stamcelleutarmning og nedsatt neurogenese. Mitochondrial dysfunction underlies cognitive defects as a result of neural stem cell depletion and impaired neurogenesis. Hum Mol Genet. 2017 Jun 8.)

(Anm: Mitochondrial dysfunction in metabolism and ageing: shared mechanisms and outcomes? Biogerontology. 2018 Aug 24.)

(Anm: Lithium Toxicity Following Vertical Sleeve Gastrectomy: A Case Report. We are presenting the first documented case of lithium toxicity after vertical sleeve gastrectomy surgery in an 18 year-old female with psychiatric history of bipolar disorder who was treated with lithium. This case illustrates the need for closer monitoring of lithium levels following bariatric surgery. Both psychiatrists and surgeons should be aware of the potential risk of lithium toxicity following bariatric surgery, as well as the need to judiciously monitor lithium level and possibly adjust the dose of some medications. Clin Psychopharmacol Neurosci. 2016 Aug 31;14(3):318-20. doi: 10.9758/cpn.2016.14.3.318.)

- Bipolar lidelse og schizofreni er forbundet med økt dødelighet i forhold til den generelle befolkningen. Det er et internasjonalt fokus på å redusere denne overdødelighet. (- Konklusjoner. Dødelighetsgapet mellom individer med bipolar lidelse og skizofreni og den generelle befolkningen øker. (...) Denne studien sammenligner alle dødelighetsårsaker, CVD-død og CVD-diagnose, selvmord- og selvskaderater hos mennesker med bipolar lidelse og skizofreni og en generell populasjonskomparatorgruppe fra 2000 til 2014.)

(Anm: Abstract Background Bipolar disorder and schizophrenia are associated with increased mortality relative to the general population. There is an international emphasis on decreasing this excess mortality. Aims To determine whether the mortality gap between individuals with bipolar disorder and schizophrenia and the general population has decreased. Method A nationally representative cohort study using primary care electronic health records from 2000 to 2014, comparing all patients diagnosed with bipolar disorder or schizophrenia and the general population. The primary outcome was all-cause mortality. Results Individuals with bipolar disorder and schizophrenia had elevated mortality (adjusted hazard ratio (HR) = 1.79, 95% CI 1.67–1.88 and 2.08, 95% CI 1.98–2.19 respectively). Adjusted HRs for bipolar disorder increased by 0.14/year (95% CI 0.10–0.19) from 2006 to 2014. The adjusted HRs for schizophrenia increased gradually from 2004 to 2010 (0.11/year, 95% CI 0.04–0.17) and rapidly after 2010 (0.34/year, 95% CI 0.18–0.49). Conclusions The mortality gap between individuals with bipolar disorder and schizophrenia, and the general population is widening. (…) This study compares all-cause mortality, CVD death and CVD diagnosis, suicide and self-harm rates in people with bipolar disorder, and schizophrenia and a general population comparator group from 2000 to 2014. The British Journal of Psychiatry Sep 2017, 211 (3) 175-181.)

(Anm: Overdødelighet, forsikringsteknisk uttrykk for at en person eller gruppe av personer statistisk sett beregnes å ha en høyere dødelighet enn normalt. Dette vil enten føre til forhøyet premie eller forsikring mot redusert erstatningsplikt for selskapet. Kilde: Store norske leksikon.)

- Ekstrem sinus bradykardi assosiert med litiumterapi.

(Anm: Extreme sinus bradycardia associated with lithium therapy. Abstract Extreme sinus bradycardia and T wave changes are described in a patient receiving lithium therapy. Ischemic heart disease was excluded by the results of radionuclide study and an exercise stress test. The electrocardiographic changes were shown to be related to lithium therapy, as documented by the inverse correlation between heart rate and plasma lithium levels. Isr J Med Sci. 1983 Apr;19(4):353-5.)

(Anm: Langsom puls, bradykardi. Hjertet er en muskel som trekker seg sammen i et rytmisk mønster gjennom hele livet. Hvert hjerteslag er stimulert av et elektrisk signal som oppstår i hjertets ledningssystem. Et normalt hjerte slår 60 til 100 slag per minutt. Noen ganger kan et problem med ledningssystemet få hjertet til å slå for fort, for langsomt eller uregelmessig. Et elektrokardiogram, et EKG, kan måle og registrere hjertets elektriske aktivitet. (nhi.no 23.2.2014 ).)

(Anm: Lithium-induced bradycardia: A rare but serious adverse effect. (clinicalpsychiatrynews.com 11.11.2017).)

- Litiumindusert nefropati.

(Anm: Lithium-Induced Nephropathy. (…) Lithium is known to cause tubulointerstitial nephropathy, which may be seen on imaging as multiple small cysts. Management of this patient’s condition included a low-salt diet and a liberal intake of fluids. His sodium level normalized, and he was discharged to a rehabilitation facility. N Engl J Med 2018; 378:1042 (March 15, 2018).)

(Anm: Nefropati, nyresykdom, fellesbetegnelse på alle nyresykdommer. Betegnelsen brukes ofte når man ikke kjenner årsaken til nyrelidelsen hos en pasient. Kilde: Store norske leksikon.)

- Å lukke dødelighetsgapet for alvorlig psykisk lidelser: går vi i riktig retning?

(Anm: EDITORIALS- Closing the mortality gap for severe mental illness: are we going in the right direction? The British Journal of Psychiatry Sep 2017, 211 (3) 130-131;.)

(Anm: Stefan Leucht, John M. Davis. EDITORIALS. Do antipsychotic drugs lose their efficacy for relapse prevention over time? Declaration of interest In the past 3 years S.L. has received honoraria for consulting from LB Pharma, Lundbeck, Otsuka, Roche, and TEVA, for lectures from AOP Orphan, ICON, Janssen, Lilly, Lundbeck, Otsuka, Sanofi, Roche, and Servier, and for a publication from Roche. The British Journal of Psychiatry Sep 2017, 211 (3) 127-129;.)

(Anm: Antidepressiva (nytteverdi) (mintankesmie.no).)

(Anm: Antipsykotika (psykofarmaka etc.) (mintankesmie.no).)

(Anm: Sovemidler (sovemedisiner) og beroligende midler (mintankesmie.no).)

(Anm: Diskriminering, feilmedisineringer hos mennesker med utviklingshemming og utfordrende atferd (psykofarmaka; antidepressiva, antipsykotika, sovemedisiner) etc. (mintankesmie.no).)

- Sammenlignet med de som tok lamotrigin hadde de som tok litium mer enn doblet risiko for hjertesvikt.

(Anm: Mors litiumbruk utgjør liten risiko for fetus (foster). Mom's Lithium Use Poses Modest Risk to Fetus. Risk in early pregnancy lower than reported in 1970s study. Infants exposed to lithium in utero in the first trimester had a modest increased risk of cardiac malformations compared with both unexposed infants and those exposed to another common mood stabilizer, a large retrospective cohort study found. Compared with unexposed infants, those who were exposed to lithium had a 65% increased risk of cardiac malformations (adjusted RR 1.65, 95% CI 1.02-2.68), albeit with a wide confidence interval, reported Elisabetta Patorno, MD, of Brigham and Women's Hospital, and colleagues. When compared with exposure to lamotrigine, those exposed to lithium had more than twofold increased risk of cardiac malformations (adjusted RR 2.25, 95% CI 1.17-4.34), the authors wrote in the New England Journal of Medicine. (medpagetoday.com 7.6.2017).)

- Litiumbruk ved graviditet og risiko for hjertesvikt.

(Anm: Lithium Use in Pregnancy and the Risk of Cardiac Malformations. Conclusions Maternal use of lithium during the first trimester was associated with an increased risk of cardiac malformations, including Ebstein’s anomaly; the magnitude of this effect was smaller than had been previously postulated. N Engl J Med 2017; 376:2245-2254 (June 8, 2017).)

- Neutrons show accumulation of antidepressant in brain

Neutrons show accumulation of antidepressant in brain
medicalnewstoday.com 30.9.2013
Experiments with neutrons at the Technische Universitat Munchen (TUM) show that the antidepressant lithium accumulates more strongly in white matter of the brain than in grey matter. This leads to the conclusion that it works differently from synthetic psychotropic drugs. The tissue samples were examined at the Research Neutron Source Heinz Maier-Leibnitz (FRM II) with the aim of developing a better understanding of the effects this substance has on the human psyche. (...)

- Läkemedel mot bipolär sjukdom kan orsaka njurskador

Läkemedel mot bipolär sjukdom kan orsaka njurskador
gu.se (Göteborgs universitet) 
Nyhet: 2014-05-26
Läkemedel som innehåller litium och som används för att behandla bipolär sjukdom kan orsaka allvarliga njurskador. Men läkemedlens nytta uppväger riskerna, och forskare vid Sahlgrenska akademin rekommenderar därför fortsatt litiumbehandling.

Litium har använts för behandling av bipolär sjukdom, även kallat manodepressiv sjukdom, sedan 1960-talet. Litiumbaserade läkemedel som Lithionit och Litarex är idag de mest effektiva som finns att tillgå för att förebygga depression och mani. Senare studier visar att behandling med litium dessutom minskar risken för självmord, och många patienter världen över är beroende av litiumbehandling för att leva ett bra liv.

Nu konstaterar forskare vid Sahlgrenska akademin att behandling med litium kan orsaka allvarliga njurskador.

Åtta gånger högre risk
Doktoranden och psykiatern Harald Aiff medverkar i en forskargrupp bestående av experter inom psykiatri och njurmedicin. I sin avhandling visar Harald Aiff att patienter som började sin litiumbehandling före 1980 löper en åtta gånger högre risk att få njursvikt som kräver dialys eller njurtransplantation.

För patienter som inledde behandlingen efter 1980 har man inte hittat några patienter som utvecklat njursvikt, vilket kan tyda på att risken har minskat avsevärt, vilket sannolikt beror på att man i början av 1980-talet införde säkrare rutiner kring litiumbehandling. (...)

(Anm: Lithium Safe, Effective for Children With Bipolar Disorder. (…)-- at least in the short term. (…) 53 children started a regimen of lithium at a standard dose, and then gradually increased to a maximum tolerated dose over the next 8 weeks if mood symptoms weren't controlled. The remaining 28 patients received placebo. (…) Some 47% of those on lithium scored in the range of “very much improved” or “much improved” on the Clinical Global Impressions Scale, compared with 21% of those on placebo. (dgnews.docguide.com 13.10.2015).)

- 240 000 kvinnor kan ha njursvikt – utan att veta om det. (- Obehandlad njursvikt kan leda till bestående njurskador, vilket i sin tur ökar risken för hjärt- och kärlsjukdom, blodbrist och högt blodtryck. Förblir njursvikten obehandlad kan detta leda till ett livshotande tillstånd.)

(Anm: 240 000 kvinnor kan ha njursvikt – utan att veta om det. Obehandlad njursvikt kan utvecklas till ett livshotande tillstånd, trots detta kan hundratusentals svenskar ha njursvikt utan att veta om det, enligt ny svensk forskning som Njurförbundet tagit del av. Obehandlad njursvikt kan leda till bestående njurskador, vilket i sin tur ökar risken för hjärt- och kärlsjukdom, blodbrist och högt blodtryck. Förblir njursvikten obehandlad kan detta leda till ett livshotande tillstånd. Runt 560 000 personer i Sverige kronisk njursvikt, men många känner inte till sin sjukdom, menar Njurförbundet som hänvisar till en studie från Karolinska Institutet.  Endast en bråkdel (14 procent) har fått diagnos eller blivit remitterade till specialist, vilket kan betyda att runt 480 000 personer är omedvetna om sin sjukdom, skriver förbundet i ett pressmeddelande.  Symtom och riskfaktorer vid njursvikt – Njursvikt är en tyst sjukdom som kommer smygande, först utan symtom. – Trötthet, nedsatt aptit, svullnad och klåda är symtom vid svår njursvikt. – Riskfaktorer är bland andra hög ålder, diabetes, högt blodtryck, övervikt, åderförkalkning och hjärt- kärlsjukdomar. Så förebygger du njursvikt  – Kontrollera blodtrycket regelbundet. Det bör ej överstiga 140/90. – Håll dig i form med motion och undvik övervikt. – Undvik rökning. – Överdriv inte intag av antiinflammatoriska läkemedel av typen NSAID, såsom diklofenak eller ibuprofen. – Har du diabetes, följ kostråden och se till att ha ett välkontrollerat blodsocker. (netdoktor.se 7.3.2018).)

(Anm: The Ibuprofen Risks You Need to Know (…) But if they’re used more frequently, or over long periods of time, they may pose dangers to the heart, kidneys, bone and even hearing. (…) “People need to be more aware of the potential downsides of long-term analgesic use,” says Dr. Gary Curhan at Brigham and Women’s Hospital, who led the hearing loss study. MORE: If You Take Ibuprofen Often, Read This (time.com 20.4.2017).)

- Lituim og stamming. (- Litiumkarbonat ble umiddelbart stoppet, og etter ca. 2 uker, var hennes stamming helt opphørt.)

A stuttering discovery of lithium toxicity. En stamming-oppdagelse av litium toksisitet (giftighet).
dgnews.docguide.com 11.2.2017
An 86-year-old female nursing home resident was typically described by the nursing staff as alert, pleasant, and conversant, although disoriented to time and place at times. She was frequently seen in the hallways, often breaking into song with her melodious voice. Her past medical history was significant for dementia, epilepsy, and bipolar disorder, for which she took lithium carbonate. One day, she complained to her nurse that she had been stuttering, finding it difficult to complete a sentence, as well as sing. This persisted for 3 more months until a lithium level was checked, and came back elevated at 2.0 mmol/L (0.6 to 1.2 mmol/L). Lithium carbonate was promptly stopped and after about 2 weeks, her stuttering had completely resolved. We found considerable interest in this case, as lithium has rarely been associated with drug-induced stuttering. We reviewed drug-induced stuttering, enumerated the medications implicated in various case reports, and discussed its mechanisms and management. (…)

(Anm: Dansk forsker sørgede for revolution i behandlingen af bipolar lidelse. I 1949 skrev en australsk læge en artikel, der skulle vise sig at revolutionere psykiatrien. Men artiklen var tæt på at blive glemt, indtil den danske læge Mogens Schou tog fat i opdagelsen og overbeviste kritikerne om resultaternes virkning. (…) Det var lige indtil den danske forsker Mogens Schou tog sagen op og bragte behandlingen ind i psykiatrien – en behandlingsform, der anslås at have sparet USA for 145 milliarder dollars i perioden fra 1970 til 1994. Det skriver Videnskab.dk. (jyllands-posten.dk 1.1.2017).)

(Anm: Bruk av antipsykotika er assosiert med en 60 % økt risiko for dødelighet hos pasienter med Alzheimers sykdom. (…) Bruk av to eller flere antipsykotika samtidig ble knyttet til nesten doblet dødsrisiko (200 %) enn ved monoterapi.) (Antipsychotic Drug Use Increases Risk of Mortality Among Patients With Alzheimer’s Disease. JOENSUU, Finland -- December 12, 2016 -- Antipsychotic drug use is associated with a 60% increased risk of mortality among patients with Alzheimer's disease, according to a study published in the Journal of Alzheimer’s Disease. The risk was highest at the beginning of drug use and remained increased in long-term use. Use of 2 or more antipsychotic drugs concomitantly was associated with almost 2 times higher risk of mortality than monotherapy.) (dgnews.docguide.com 12.12.2016).)

3. Lithium – Renale organtumorer (EPITT nr. 18090)
ema.europa.eu (22. januar 2015 EMA/PRAC/63323/2015 Udvalget for Risikovurdering inden for Lægemiddelovervågning)
På baggrund af de foreliggende data har PRAC vedtaget, at der er tilstrækkelig dokumentation til at konkludere, at langvarig anvendelse af lithium kan bevirke mikrocyster, onkocytomer og karcinomer i samlerørene i nyrerne. Indehaverne af markedsføringstilladelse for lægemidler indeholdende lithium skal derfor inden 2 måneder indsende en ansøgning om ændring af produktinformationen som beskrevet nedenfor (ny tekst er understreget). Desuden skal der foretages rutinemæssig lægemiddelovervågning for at karakterisere risikoen bedre.

Produktresumé: 4.4 Særlige advarsler og forsigtighedsregler vedrørende brugen

Nyretumorer: Der er beskrevet mikrocyster, onkocytomer og karcinom i nyrernes samlerør hos patienter med svært nedsat nyrefunktion, som har fået lithium i mere end 10 år (se pkt. 4.8). (...)

- Lederartikler. De forsømte psykologiske aspekter ved hudsykdom.

(Anm: Lederartikler. De forsømte psykologiske aspekter ved hudsykdom. (Editorials. The neglected psychological aspects of skin disease) Hudtilstander kan ha skadelige effekter på de fleste aspekter av en persons liv, inkludert relasjoner, arbeid, sosiale funksjoner, idrettsaktiviteter og til slutt psykisk helse. (Skin conditions can have a detrimental effect on most aspects of a person’s life, including relationships, work, social functioning, sporting activities, and ultimately their mental health. BMJ 2017;358:j3208 (Published 06 July 2017).)

- Det viste sig, at folk fra områder, hvor drikkevandet indeholdt de højeste koncentrationer af lithium - over 15 mikrogram per liter - havde 17 procent reduceret risiko for demens. (- Forskerne understreger dog, at der er brug for mere forskning, før man ved, om det er de lave koncentrationer af lithium i drikkevandet sig selv, der beskytter mod demens.)

(Anm: Dansk studie: Lithium i drikkevandet kobles til mindre risiko for demens. Jo mere lithium, der er i danskernes drikkevandet, des sjældnere får de demens, viser et nyt studie. (…) 73.731 af dem havde demens, mens de resterende 733.653 ikke var ramt af sygdommen. Det skriver Videnskab.dk. Forskerne målte lithium-indholdet i drikkevandet 151 steder i Danmark. Det viste sig, at folk fra områder, hvor drikkevandet indeholdt de højeste koncentrationer af lithium - over 15 mikrogram per liter - havde 17 procent reduceret risiko for demens. Resultaterne er netop publiceret i det meget anerkendte videnskabelige tidsskrift JAMA Psychiatry. (...) Lithium kan også beskytte mod selvmord, viser forskning, og der er tidligere fundet en sammenhæng mellem lithium i drikkevand og reduceret risiko for at begå selvmord. Jo højere koncentration af stoffet, der er i drikkevandet, des lavere er risikoen for, at folk begår selvmord, viser blandt andet en østrigsk undersøgelse. (...) Forskerne understreger dog, at der er brug for mere forskning, før man ved, om det er de lave koncentrationer af lithium i drikkevandet sig selv, der beskytter mod demens. Læger advarer: Der er ikke nok viden om ny fødselstrend Forskere fra de Nationale Geologiske Undersøgelser for Danmark og Grønland (GEUS) har i forbindelse med det nye studie, for første gang lavet målinger af lithium i det danske drikkevand. »Lithium findes naturligt i dansk grundvand, men kun i meget lave koncentrationer. Nogle andre lande har langt højere koncentrationer,« siger Jörg Schullehner til Videnskab.dk. Han er postdoc på GEUS og har været med til at lave kortlægningen, som er publiceret i det videnskabelige tidsskrift Geosciences. (jyllands-posten.dk 25.8.2017).)

Clinical & Research NewsMany Bipolar Patients Face Multiple Medical Illnesses
Psychiatr News November 17, 2006
Volume 41, Number 22, page 21
© 2006 American Psychiatric Association
(...) Lithium treatment for bipolar illness might be responsible for the hypothyroidism and kidney failure from which the bipolar group suffered significantly more often than did the controls. (...)

(Anm: Autoimmune attack underlying kidney failure. Interstitial nephritis, a common cause of kidney failure, has a complex and largely unknown pathogenesis. In a new published paper in The Journal of the American Society of Nephrology, a team of researchers led from Karolinska Institutet shows how interstitial nephritis can develop from an autoimmune attack on the kidney's collecting duct. (medicalnewstoday.com 24.3.2016).)

Lithium, Inositol, and Mitochondria
ACS Chem Neurosci. 2014 Jun 2. [Epub ahead of print]
Abstract Our recent DNA-microarray and proteomics studies searching for pathways affected both by chronic lithium treatment and by knockout of each of two genes (IMPA1 or Slc5a3) encoding for proteins related to inositol metabolism, indicated up-regulation of mitochondria-related genes and autophagy-related proteins in the frontal cortex. Differently from previously reported observations of aberrant mitochondrial function in bipolar patients which leave a causality relationship between mitochondrial dysfunction and bipolar disorder an open question, the behavioral results of our recent report following rotenone treatment tempt us to speculate that mitochondrial dysfunction predisposes manic behavior and that drugs targeted to ameliorate mitochondrial function are potential preventers of bursting manic episodes. However, the promiscuity of the involvement of mitochondrial dysfunction and impaired autophagy in the pathophysiology of psychiatric and neurodegenerative disorders raises questions regarding the credibility and relevance of these findings. (…)

- Litium skyddar mot självmord. (- Risken för självmord och självmordsförsök minskade med 14 procent under behandling med litium jämfört med när samma individer stod utan behandling.)

(Anm: Litium skyddar mot självmord. Under perioder med litiumbehandling minskar självmord och försök till självmord bland personer med bipolär sjukdom. Det visar en stor registerstudie gjord vid Karolinska Institutet som publiceras i The American Journal of Psychiatry. Drygt en procent av jordens befolkning lider av bipolär sjukdom. Sjukdomen kännetecknas av växelvisa faser med onormal upprymdhet och uttalad nedstämdhet. (…) – Vi har nu starka belägg för att litiumbehandling förebygger självmordsförsök och självmord. Vi uppskattar att mer än tio procent av försöken och de fullbordade självmorden i vår undersökning hade kunnat förhindras om de här personerna hade stått på kontinuerlig litiumbehandling, säger Paul Lichtenstein, professor vid institutionen för medicinsk epidemiologi och biostatistik, Karolinska Institutet. (…) I studien, som är ett samarbete med Göteborgs universitet, har forskarna studerat drygt 51 000 personer med bipolär sjukdom från det svenska nationella patientregistret under en period av åtta år (2005-2013). Mellan dessa år inträffade 10 648 självmordsrelaterade händelser. (…) Risken för självmord och självmordsförsök minskade med 14 procent under behandling med litium jämfört med när samma individer stod utan behandling. Studien visar också att behandling med valproinsyra, det vanligaste alternativet till litium, troligen inte har någon effekt alls på självmordsbeteende. (lakemedelsvarlden.se 9.6.2017).)

(Anm: Lägre risk för självmord med litiumbehandling. En registerstudie visar lägre risk för självmordsförsök hos patienter med bipolär sjukdom som fick litium. (dagensmedicin.se 12.6.2017).)

Diverse artikler

(Anm: People with family history of bipolar disorder may 'age' more quickly than others. New King's College London research suggests that people with a family history of bipolar disorder may 'age' more rapidly than those without a history of the disease. The study, published today in Neuropsychopharmacology, also shows that bipolar patients treated with lithium -- the main medication for the illness -- have longer telomeres (a sign of slower biological aging) compared to bipolar disorder patients not treated with lithium. This suggests that the drug may mask the aging effects associated with bipolar disorder, or even help to reverse it. (news-medical.ne 26.7.2017).)

Lithium in the brain
Neutrons show accumulation of antidepressant in brain
tum.de 26.9.2013
Experiments with neutrons at the Technische Universität München (TUM) show that the antidepressant lithium accumulates more strongly in white matter of the brain than in grey matter. This leads to the conclusion that it works differently from synthetic psychotropic drugs. The tissue samples were examined at the Research Neutron Source Heinz Maier-Leibnitz (FRM II) with the aim of developing a better understanding of the effects this substance has on the human psyche.

At present lithium is most popular for its use in rechargeable batteries. But for decades now, lithium has also been used to treat various psychological diseases such as depressions, manias and bipolar disorders. But, the exact biological mode of action in certain brain regions has hardly been understood. It is well known that lithium lightens moods and reduces aggression potential.

Because it is so hard to dose, doctors have been reluctant to prescribe this “universal drug”. Nonetheless, a number of international studies have shown that a higher natural lithium content in drinking water leads to a lower suicide rate in the general population. Lithium accumulates in the brains of untreated people, too. This means that lithium, which has so far been regarded as unimportant, could be an essential trace element for humans. (...)

(Anm: Antidepressants may increase later onset of mania, bipolar. People diagnosed with unipolar depression have a higher chance of developing mania or bipolar disorder if they’ve previously been treated with antidepressants, a new study shows (BMJ Open. 2015 Dec 15. doi: 10.1136/bmjopen-2015-008341). “Our findings demonstrate a significant association between antidepressant therapy in patients with unipolar depression and an increased incidence of mania,” Dr. Rashmi Patel of King’s College, London, and his associates reported in the study. Moreover, the association remains significant after adjusting for both age and gender, they wrote. (clinicalpsychiatrynews.com 15.12.2015).)

Dansk forsker frikender lithium for kræftmistanke
dagenspharma.dk 6.5.2015
Undersøgelse fra Syddansk Universitet finder ingen øget risiko for nyrekræft ved brug af lægemidlet lithium og afviser dermed konklusion fra franske forskere.

Forskere fra Syddansk Universitet har renset lithium for mistanke om at øge risikoen for nyrekræft og sikret, at lithium fortsat kan bruges til behandling af psykiatriske patienter Kræftmistanken blev vakt i 2014, da franske forskere meldte ud, at lægemidlet lithium, som er et effektivt lægemiddel til behandling af psykiske lidelser, øger risikoen for nyrekræft. Dermed […]

(Anm: Do antidepressants increase the risk of mania and bipolar disorder in people with depression? A retrospective electronic case register cohort study. BMJ Open  2015;5:e008341 (Published 14 December 2015).)

(Anm: Bipolar disorder linked to inherited differences in sleep patterns. A recent study published in the Proceedings of the National Academy of Sciences finds links between sleeping patterns, circadian rhythms, bipolar disorder and specific phenotypes. (…) Twin studies have already shown that there is a genetic component to some sleep parameters. For instance, the quantity of rapid eye movement (REM) and delta sleep that an individual has during a night's sleep is more similar in people who are more genetically alike. (medicalnewstoday.com 2.1.2016).)

(Anm: Circadian rhythm length variations - early birds and night owls. (news-medical.net 11.4.2017).)

(Anm: Leukoaraiosis is associated with short- and long-term mortality in patients with intracerebral hemorrhage. J Stroke Cerebrovasc Dis. 2013 Oct;22(7):919-25. Epub 2013 Feb 21.)

(Anm: Personality traits linked to differences in brain structure. Our personality may be shaped by how our brain works, but in fact the shape of our brain can itself provide surprising clues about how we behave - and our risk of developing mental health disorders - suggests a study published in Social Cognitive and Affective Neuroscience.  (medicalnewstoday.com 26.1.2017).)

(Anm: Sleep Disordered Breathing and White Matter Hyperintensities in Community-Dwelling Elders. To examine the association between markers of sleep-disordered breathing (SDB) and white matter hyperintensity (WMH) volume in an elderly, multiethnic, community-dwelling cohort. (…) Conclusions: In community-dwelling older adults, self-reported measures of SDB are associated with larger WMH volumes. The cognitive effects of SDB that are increasingly being recognized may be mediated at the small vessel level.Sleep. 2016;39(4):785–791).)

Litium gjør telomerene lengre
aftenposten.no 31.5.2013
Endene på kromosomene våre, telomerene, henger nøye sammen med hvor lenge vi lever og hvordan kroppen vår takler stress, betennelser, psykisk sykdom og aldring i sin allminnelighet. Etter som telomerene forkortes, slutter cellene å dele seg, og aldringen akselererer. I en studie publisert i Nature viser forskere ved Karolinska institutet at psykofarmakumet litium, som anvendes ved bipolar sykdom, gjør at telomerene blir lengre. (...)

Längre telomerer efter behandling med litium
ki.se 24.5.2013
[NYHET 2013-05-24] En ny studie från Karolinska Institutet visar att behandling med litium vid bipolär sjukdom i vissa fall kan öka längden på de så kallade telomererna, gensekvenser i ändarna på cellkärnans kromosomer. Förkortning av telomererna har tidigare kopplats till åldrande, stress och psykisk sjukdom. Forskarna hoppas nu att resultaten ska vara ett första steg på vägen mot en mer individualiserad behandling av bipolär sjukdom. (...)

(Anm: Long-term lithium treatment in bipolar disorder is associated with longer leukocyte telomeres. Translational Psychiatry (2013) 3, e261 ( Published online 21 May 2013).)

Lithium and Down Syndrome
Ivanhoe.com 10.12.2012
(Ivanhoe Newswire) – There are more than 400,000 people living with Down syndrome in the United States, according to the National Down Syndrome Society. The genetic disorder is the most common single cause of human birth defect, and occurs when a person has 47 chromosomes instead of the usual 46.

The extra chromosome causes problems with the way the body and brain develop. In the brain, Down syndrome results in alterations in the connections between neurons and a reduction in the development of new neurons, called neurogenesis, that usually occurs during learning.

Now, researchers say Lithium may help Down syndrome patients. Published in the most recent issue of the Journal of Clinical Investigation, researcher Laura Gasparini at the Istituto Italiano di Tecnologia in Genova, Italy reported that the drug, which is commonly used to treat mood disorders, restores neurogenesis, or the development of new neurons, in the hippocampus, the part of the brain associated with learning and memory.

Lithium also significantly improved the performance of Down syndrome mice in tasks measuring contextual learning, spatial memory, and object discrimination. These results suggest that lithium-based therapies may help Down syndrome patients, said Gasparini and co-authors. (...)

(Anm: Lithium rescues synaptic plasticity and memory in Down syndrome mice. Journal of Clinical Investigation 2012 (Published December 3, 2012).)

Chronic renal failure in lithium-using geriatric patients: effects of lithium continuation versus discontinuation-a 60-month retrospective study
Int J Geriatr Psychiatry. 2012 Jun 4. doi: 10.1002/gps.3841. [Epub ahead of print]
OBJECTIVE: Lithium remains an important treatment in bipolar disorder. Although lithium is often discontinued because of signs of renal failure, it is unclear if this alters the course of renal function in the majority of patients. We hypothesize that in geriatric patients with chronic renal failure (CRF), who have a high burden of medical illness, lithium continuation does not significantly impact renal function (glomerular filtration rate (eGFR)). (...)

CONCLUSIONS: There was a trend towards declining renal function in lithium continuers at 60-month follow-up. Future prospective longitudinal studies will be needed to confirm our findings. We suggest vigilance and close monitoring of renal function when continuing CRF patients on lithium for extended periods. (...)

Lithium toxicity profile: a systematic review and meta-analysis
Lancet. 2012 Feb 25;379(9817):721-8. Epub 2012 Jan 20
(...) BACKGROUND: Lithium is a widely used and effective treatment for mood disorders. There has been concern about its safety but no adequate synthesis of the evidence for adverse effects. We aimed to undertake a clinically informative, systematic toxicity profile of lithium. (...)

INTERPRETATION: Lithium is associated with increased risk of reduced urinary concentrating ability, hypothyroidism, hyperparathyroidism, and weight gain. There is little evidence for a clinically significant reduction in renal function in most patients, and the risk of end-stage renal failure is low. The risk of congenital malformations is uncertain; the balance of risks should be considered before lithium is withdrawn during pregnancy. Because of the consistent finding of a high prevalence of hyperparathyroidism, calcium concentrations should be checked before and during treatment. (...)

The Immunostimulating and Antimicrobial Properties of Lithium and Antidepressants
inewp.com 4.2.2012
(...) Selective serotonin reuptake inhibitors (SSRIs) can destroy such fungi in vitro as Candida and Aspergillus species.[84] Sertraline can remit recurrent vulvovaginal candidiasis in vivo.[85] Munoz-Bellido and colleagues have shown that such antidepressants as sertraline, fluoxetine and paroxetine have antimicrobial activity especially against Gram-positive microorganisms. These anti-depressants also show synergistic activity when combined with some antibiotics against several bacteria.[86] In a separate study Munoz-Bellido andcolleagues tested the in vitro activity of various antibiotics and psychotropic drugs against 32 strains of Corynebacterium urealyticum. Sertraline was the most effective psychiatric drug and it enhanced the activity of ciprofloxacin and tetracycline against all strains.[87] (...)

(...) Depression, antidepressants and immunity
The depressive effect of bereavement and other stresses on immune function is well documented.[88] Impaired lymphocyte function, reduced natural killer cell activity, reduced lymphocyte responses to mitogens and decreased natural killer cellpopulations have been demonstrated in depressives.[89,90] Antidepressants augment natural killer cell activity in vivo and in vitro.[91] The MAOI tranylcypromine enhances cell-mediated immunity.[92] (...)

While lithium is effective against some bacteria and viruses evidence for effectiveness against parasites and fungi is lacking. Antidepressants, on the other hand, are effective against various bacteria, viruses, parasites and fungi. As lithium and anti-depressants have immunopotentiating as well as antimicrobial properties they stand to be effective against a gamut of microorganisms. The response of infection to lithium and antidepressants mirrors depression with subjects responding to TCAs, to SSRIs, to MAOIs or to lithium. An infection should not be labeled refractory to antidepressants untilmany, if not all have been tried. Many comparison studies with antidepressants are biased by the generalization that ‘antidepressants’ lack a specific property when the study involved only one. Anti-depressants are highly specific and humans remarkably variable.

Excessive synthesis of PGs depresses brain and immune function. When depressives with an infection respond to lithium or an antidepressant the response is invariably simultaneous, suggesting that the central actions of the drugs are important.

The immunostimulating actions of lithium and anti-depressants are systemic and suggest central orchestration. While antivirals are not necessarily immunostimulants, the actions of lithium and anti-depressants suggest that immunostimulants are antivirals. The SARS epidemic was a clarion call for immunostimulants. The immunostimulating properties of lithium and antidepressants could transform the prevention and treatment of many such infections.

Tachyphylaxis may complicate the treatment of depression[99 – 101] and paradoxical reactions induce or intensify symptoms. These phenomena may interfere with the treatment of infection with lithium and antidepressants. Antidepressants are, paradoxically, capable of activating dormant viruses.[102] Remission of depression in subjects treated for tuberculosis ushered in the pharmaco-logical treatment of depression.

The wheel will turn full circle when lithium and antidepressants are integrated into the pharmacology and therapeutics of infection. (...)

Lithium toxicity profile: a systematic review and meta-analysis
Lancet. 2012 Jan 19. [Epub ahead of print]
(...) BACKGROUND: Lithium is a widely used and effective treatment for mood disorders. There has been concern about its safety but no adequate synthesis of the evidence for adverse effects. We aimed to undertake a clinically informative, systematic toxicity profile of lithium. (...)

INTERPRETATION: Lithium is associated with increased risk of reduced urinary concentrating ability, hypothyroidism, hyperparathyroidism, and weight gain. There is little evidence for a clinically significant reduction in renal function in most patients, and the risk of end-stage renal failure is low. The risk of congenital malformations is uncertain; the balance of risks should be considered before lithium is withdrawn during pregnancy. Because of the consistent finding of a high prevalence of hyperparathyroidism, calcium concentrations should be checked before and during treatment. (...)

Lithium Carbonate 150 mg, 300 mg, and 600 mg capsules
fda.gov (October 2011)
Detailed View: Safety Labeling Changes Approved By FDA Center for Drug Evaluation and Research (CDER) – October 2011

Summary View

Unmasking of Brugada Syndrome
...the unmasking of Brugada Syndrome [added]

Information for the Patients
...the unmasking of Brugada Syndrome [added]

...the unmasking of Brugada Syndrome [added] (...)

(Anm: Brugada Syndrome (Tidsskr Nor Legeforen 2008; 128:2828-31 (18.12.2008).)

Lithium-Associated Hyperthyroidism Treated With Lithium Withdrawal: A Case Report
Am J Psychiatry 2011;168:438-439 (April)
TO THE EDITOR: Lithium, a first-line treatment for bipolar disorder, is a well-known cause of hypothyroidism; however, case reports have documented the emergence of thyrotoxicosis during lithium treatment, with evidence showing the incidence rate to be greater than expected in the general population (1–3). The recommended conservative management is antithyroid medication and continuation of lithium (4). It is advised that lithium not be withdrawn because of several reports of exacerbation of thyrotoxicosis (1, 2, 5). We report the case of a patient with lithium-associated hyperthyroidism treated with drug withdrawal, a treatment method documented in only one previous case (6). (...)

Theories that lithium causes hyperthyroidism include induction of autoimmunity and direct toxic effect causing thyroid hormone release (4). Notably, the three reports of exacerbation of thyrotoxicosis after withdrawal of lithium were in patients with Graves' disease. Conversely, our patient, who presented with thyroiditis, improved after withdrawal of lithium, which is consistent with the theory of lithium's direct toxic effect on thyrocytes. One could conclude that management of lithium-associated hyperthyroidism would differ based on the etiology of the thyroid overactivity. Our case suggests that patients who present with thyroiditis can be effectively treated with withdrawal of lithium. (...)

Experts: Lithium doesn't slow Lou Gehrig's disease
seattletimes.nwsource.com 6.4.2010
Lithium doesn't help patients with ALS, or Lou Gehrig's disease, contrary to previous study results, new research says.

LONDON — Lithium doesn't help patients with ALS, or Lou Gehrig's disease, contrary to previous study results, new research says.

Results from a small study published two years ago suggested the drug, often used for depression, could slow the fatal neurological disorder. Many ALS sufferers and their families rushed to try it, spearheading a patient-led effort to test lithium without doctors.

In the first trial to scientifically assess whether lithium works for Lou Gehrig's disease, doctors found it had no effect - and stopped the study early because it seemed futile. The results were published online Tuesday in the medical journal, Lancet Neurology. (...)

A young woman's myterious case of fatigue and confusion
clinicaladvisor.com 21.1.2010
Amber, a 23-year-old day-care worker, was brought by ambulance to the ER with symptoms of severe fatigue. Two days earlier, she had presented at the same ER with fatigue, malaise, and acute vomiting and diarrhea. At that time, she was diagnosed with a viral infection. (...)

Lithium is almost (90%-100%) completely absorbed from the GI tract and cleared primarily through the kidneys. It is not metabolized, and its clearance is directly dependent upon the glomerular filtration rate. As a result, dosing must be adjusted based on renal function. Serum lithium levels will peak two to four hours after ingestion; the half-life of the drug ranges from 12 to 27 hours. Several drug classes have the potential to increase lithium levels, including nonsteroidal anti-inflammatory drugs, ACE inhibitors, and calcium channel blockers. These should be used with caution in conjunction with lithium therapy.

In early stages, lithium toxicity often goes unnoticed because of its vague presentation of mild intoxication (nausea, vomiting, diarrhea, and general malaise). The initial physical examination of a patient with mild lithium overdose may be normal. As the toxicity progresses, later symptoms, such as confusion, tremors, seizure, or even coma, make the diagnosis more evident. (...)

In Amber's case, the lithium toxicity was initially misdiagnosed as a simple viral infection. It was not until the second visit and an increase in toxicity that the correct diagnosis was made. Although a potentially fatal outcome was averted, dialysis might have been avoided had earlier diagnosis occurred. (...)

(Anm: Calcium channel blocker (kalsiumblokkere; kalsiumantagonister, kalciumantagonister) (en.wikipedia.org).)

Lithium and chronic kidney disease
BMJ 2009;339:b2452 (3 July)
Lithium use is associated with renal disorder and renal failure; this article offers guidance on monitoring, drug interactions, and when to consider stopping the drug (...)

This article discusses the effects of lithium on the kidney and looks at existing evidence to guide treatment when incidental chronic kidney disease is detected in those in whom lithium is being considered or when long term lithium users develop chronic kidney disease. (...)

How should renal function be monitored in lithium therapy?
Although our recommendations extrapolate evidence from high quality diagnostic studies used to develop the NICE guideline on chronic kidney disease, it remains uncertain how lithium users differ from those at risk of the disease because of hypertension, diabetes, or use of non-steroidal anti-inflammatory drugs. (...)

(Anm: Objective To describe the estimated prevalence and temporal trends of chronic kidney disease (CKD) treatment patterns, and the association between CKD and potential factors for type 2 diabetes mellitus (T2DM) in different demographic subgroups. (…) Conclusions CKD continued to be prevalent in the T2DM population; prevalence remained fairly consistent over time, suggesting that current efforts to prevent CKD could be improved overall, especially by monitoring certain populations more closely. BMJ Open Diab Res Care  2016;4:e000154.)

(Anm: Chronic Kidney Disease (CKD) (webmd.com 18.12.2016).)

(Anm: LNT - Landsforeningen for Nyrepasienter og Transplanterte (lnt.no).)

(Anm: LNT - Statistikk (lnt.no).)

(Anm: Chronic kidney disease and cardiovascular risk in six regions of the world (ISN-KDDC): a cross-sectional study. (…) Interpretation. Prevalence of chronic kidney disease was high in general and high-risk populations from countries of low and middle income. Moreover, awareness of chronic kidney disease and other non-communicable diseases was low, and a substantial number of individuals who knew they were ill did not receive treatment. Prospective programmes with repeat testing are needed to confirm the diagnosis of chronic kidney disease and its risk factors. Furthermore, in general, health-care workforces in countries of low and middle income need strengthening.Lancet Glob Health 2016;4(5):e307–19 (May 2016).)

(Anm: Non-communicable disease (NCD) (en.wikipedia.org).)

(Anm: Reduksjon i ikke-smittsomme sykdommer – nasjonal oppfølging av WHOs mål. (helsedirektoratet.no 26.11.2017).)

(Anm: New health analysis in India finds increase in non-communicable diseases. (Ny helseanalyse i India finner økning i ikke-smittsomme sykdommer.) (news-medical.net 1.1.2013).)

(Anm: Reduksjon i ikke-smittsomme sykdommer – nasjonal oppfølging av WHOs mål. (helsedirektoratet.no 26.11.2017).)

(Anm: New health analysis in India finds increase in non-communicable diseases. (Ny helseanalyse i India finner økning i ikke-smittsomme sykdommer.) (news-medical.net 1.1.2013).)

(Anm: Ikkje-smittsame sjukdomar. Avdelinga har som hovudansvar å koordinere og drive forsking og helseanalyse innan ikkje-smittsame sjukdomar som hjarte- og karsjukdomar, type 2-diabetes, kreft og lungesjukdomar. (fhi.no).)

(Anm: IgA Nephropathy: New Aspects in Pathophysiology and Pathogenesis. (…) This disease may also be acquired depending on numerous environmental factors: exposure to certain exoantigens (infectious organisms, food, etc.), involvement of specific cytokines that can induce the production of Gd-IgA1, and modification of the different players potentially involved (immune response to autoantigens, abnormalities in receptors such as TfR and CD89, tissue TG2 status, etc.). EMJ Neph. 2015;3[1]:97-103.)

(Anm: Autoimmun attack kan ligga bakom njursvikt. Interstitiell nefrit, som är en vanlig orsak till njursvikt, har en komplex och i stora delar okänd bakgrund. Nu visar forskare i en studie ledd från Karolinska institutet hur interstitiell nefrit kan utvecklas genom en autoimmun attack mot njurens samlingsrör. Fynden publiceras i tidskriften Journal of the American Society of Nephrology (JASN). (ki.se 11.11.2015) (Karolinska Institutet).)

(Anm: Identification of a driver of fibrosis in chronic kidney disease. (medicalnewstoday.com 22.1.2016).)

(Anm: Chronic kidney disease in elderly people: disease or disease label? Timothy Ellam and colleagues argue for a focus on what diagnosis means for individual patients rather than population risks. Around half of people aged over 75 meet current diagnostic criteria for chronic kidney disease (CKD). However, labelling them all as diseased is controversial and may cause unnecessary anxiety.1 2 The classification system defining this epidemic of CKD in elderly people is validated primarily as an epidemiological risk stratification tool rather than a clinical aid to patient management. We highlight the need to focus the debate on improving patient centred outcomes rather than just identifying everyone at above average risk. BMJ 2016;352:h6559 (Published 18 January 2016).)

(Anm: Polycystic kidney disease: a diet dividend. New research from UC Santa Barbara suggests that reducing food intake may slow the growth of the cysts that are symptomatic of PKD, an inherited disorder in which clusters of cysts develop in the kidneys. (medicalnewstoday.com 29.1.2016).)

(Anm: Mitochondria: a new therapeutic target in chronic kidney disease. Nutr Metab (Lond). 2015 Nov 25;12:49.) (PDF)

(Anm: Chronic kidney disease may cause diabetes. A team from the University of Montreal Hospital Research Centre (CRCHUM) has discovered a novel link between chronic kidney disease and diabetes. When kidneys fail, urea that builds up in the blood can cause diabetes, concludes a study published today in the Journal of Clinical Investigation. (medicalnewstoday.com 16.8.2016).)

(Anm: Kidney Impairment Decreases Blood Flow to the Brain, Boosting Risk of Stroke and Dementia (dgnews.docguide.com 6.8.2015).) 

(Anm: Chronic kidney disease may cause diabetes. A team from the University of Montreal Hospital Research Centre (CRCHUM) has discovered a novel link between chronic kidney disease and diabetes. When kidneys fail, urea that builds up in the blood can cause diabetes, concludes a study published today in the Journal of Clinical Investigation. (medicalnewstoday.com 16.8.2016).) (PDF)

(Anm: Abdominal Obesity Is More Closely Associated With Diabetic Kidney Disease Than General Obesity. Diabetes Care  2016 Aug; dc161025).) 

(Anm: Mitochondrial Dysfunction and Signaling in Diabetic Kidney Disease: Oxidative Stress and Beyond. Abstract The kidneys are highly metabolic organs that produce vast quantities of adenosine triphosphate via oxidative phosphorylation and, as such, contain many mitochondria. Although mitochondrial reactive oxygen species are involved in many physiological processes in the kidneys, there is a plethora of evidence to suggest that excessive production may be a pathologic mediator of many chronic kidney diseases, including diabetic kidney disease. (…) Accordingly, in this review, mitochondrial dysfunction in a broader context is discussed, specifically focusing on mitochondrial respiration and oxygen consumption, intrarenal hypoxia, oxidative stress, mitochondrial uncoupling, and networking. Semin Nephrol. 2018 Mar;38(2):101-110.) 

(Anm: Kidney Function: What Do The Kidneys Do? Contents of this article: 1.Structure and function of the kidneys 2.Diseases of the kidney and their cause 3. Kidney dialysis and maintaining healthy kidneys. (medicalnewstoday.com 4.2.2016).)

(Anm: IgA Nephropathy. What is IgA nephropathy? IgA nephropathy is a kidney disorder that occurs when IgA—a protein that helps the body fight infections—settles in the kidneys. After many years, the IgA deposits may cause the kidneys to leak blood and sometimes protein in the urine. (niddk.nih.gov).) 

(Anm: Even small reductions in kidney function may damage heart, blood vessels. Even small reductions in kidney function are associated with heart and blood vessel damage, according to new research in the American Heart Association's journal Hypertension. (medicalnewstoday.com 8.1.2016).)

Lithium, antipsychotics, and risk of psoriasis.
J Clin Psychopharmacol. 2009 Apr;29(2):134-40.
(...) CONCLUSIONS: Long-term use of lithium was associated with a small increase in risk of incident psoriasis. (...)

Oppfølging av pasienter som bruker litium
MEDISIN OG VITENSKAP Legemidler i praksis
Tidsskr Nor Legeforen 2008; 128:1410-2 (12.6.2008)
I mer enn 50 år har litium vært blant de viktigste legemidler i behandlingen av psykiske lidelser. Hovedindikasjonen er behandling og forebygging av bipolar lidelse (manisk-depressiv sykdom). Litium brukes også i behandlingen av affektive symptomer ved schizofreni og andre psykiske lidelser. Effekten er godt dokumentert, men midlet kan gi alvorlige bivirkninger og interaksjoner med andre legemidler. Litium har et smalt terapeutisk område og intoksikasjoner kan forekomme ved vanlige/lave doser. (...)

Hasjrøyking fremmer sinnslidelser
nrk.no 22.8.2007
Ny forskning viser at hasjrøyking øker risikoen for alvorlige sinnslidelser som psykose og schizofreni. Professor i sosiologi ønsker nå Frederic Hauge med på laget i en kampanje mot hasjrøyking. (...)

(Anm: 50.000 nordmenn vil utvikle schizofreni i løpet av livet. - De som lider av denne psykoselidelsen har tanker om verden som ikke stemmer, sier ekspert. (…) Uklare symptomer i starten. Symptomer på Schizofreni utvikler seg over tid, og er i starten litt uklare. Ofte blir de mer fremtredende etter hvert. - Da vises blant annet sosial tilbaketrekning, man mister kontakt med virkeligheten, har vrangforestillinger, hallusinasjoner, tap av matlyst og tap av hygiene. Det er store individuelle variasjoner og mange opplever det som en berg- og dalbane, sier Tove Gundersen, som er generalsekretær i Rådet for psykisk helse. (kk.no 26.9.2016).)

(Anm: Katteparasitt kan gi schizofreni og tvangslidelser. Forskere har funnet en sammenheng mellom katteparasitten Toxoplasma gondii og utviklingen av forskjellige psykiske lidelser hos mennesker. (…) En parasitt fra katteavføring, T. gondii, kan sette fast seg i menneskehjernen og føre til schizofreni, manisk depressiv sinnslidelse, avhengighet og tvangstanker. (nrk.no 29.6.2015).)

(Anm: Så tar kattparasiten kontroll över dina celler. I Sverige bär var femte person på infektionen toxoplasmos som orsakas av parasiten Toxoplasma gondii. Den kan enligt studier påverka ditt psyke och kan i vissa fall vara livshotande. Nu har forskare vid Stockholms universitet upptäckt hur parasiten tar över våra celler. – Vi har avkodat hur parasiten bär sig åt för att ta över kontrollen av immunceller, det vill säga omvandla dem till rörliga 'zombier' som sprider parasiten i kroppen”, skriver professorn Antonio Barragan som är en av författarna till den nya studien, enligt forskning.se. (netdoktor.se 11.12.2017).)

(Anm: No, Your Cat Isn't a Threat to Your Mental Health. (…) But mental health worries aside, pregnant women should still be cautious about exposure to cat litter boxes, another researcher warned. "There is good evidence that T. gondii exposure during pregnancy can lead to serious birth defects and other health problems in children," said study senior author Dr. James Kirkbride. (medicinenet.com 21.2.2017).)

(Anm: Angstbehandling spres til utlandet. Her er nederlandske psykologer i Bergen for å lære om behandlingen som kan kurere tvangstanker på fire dager. Nå spres behandlingsopplegget til andre sykdommer og utover Norges grenser. (dagensmedisin.no 21.12.2016).)

(Anm: Schizofreni kopplas till TBE-smitta. Det kan finnas en koppling mellan virusinfektioner som TBE och neuropsykiatriska sjukdomar som schizofreni. Det har svenska forskare kommit fram till i en studie som presenterades på en konferens i San Diego på måndagen. (svd.se 6.11.2007).)

(Anm: Scientists find chemical pathway responsible for schizophrenia symptoms. Recent studies have suggested that kynurenic acid (KYNA) plays a key role in the pathophysiology of schizophrenia. People with schizophrenia have been shown to possess higher levels of KYNA than healthy individuals. KYNA helps to metabolize tryptophan - an essential amino acid that, in turn, helps the body to produce the "happiness" neurotransmitter serotonin, and the vitamin niacin. (medicalnewstoday.com 9.2.2017).)

(Anm: Psykose. Alle mennesker kan utvikle psykose. - Balansegangen mellom opplevd stress og ballast til å stå imot, er avgjørende, forteller psykiater. (…) - Stress er et sentralt tema. For eksempel har vi forskjellige måter å takle en belastende hendelse på jobb på. (…) - Man kan kalle det en forvirringstilstand, selv om heller ikke det er helt dekkende. (…) Symptomer ved psykose. Tidlige tegn kan være at man: (…) - Det er en kjempebelastning å ha en psykose. Mange blir redde og opplever ting de ikke forstår. Man vet at noen mennesker kan få tanker og impulser om å ta sitt eget liv, legger hun til. (lommelegen.no 13.6.2016).)

(Anm: Samtaleterapi styrker hjernens forbindelser for behandling av psykose. (Talk therapy strengthens brain connections to treat psychosis. Cognitive behavior therapy is used to help treat a number of mental health conditions, including anxiety, depression, and post-traumatic stress disorder. For the first time, researchers have shown how this type of therapy triggers brain changes to produce long-term benefits for patients with psycosis. Researchers have found evidence to suggest that talk therapy can alter the brain in a way that leads to long-term recovery from psychosis. Lead study author Dr. Liam Mason, of King's College London in the United Kingdom, and colleagues report their findings in the journal Translational Psychiatry.) (medicalnewstoday.com 22.1.2017).)

(Anm: Forskningen på schizofreni og psykose er i dyp krise | Paul Møller, dr. med. og spesialist i psykiatri. Hjernen kan måles, veies og avbildes eksakt og detaljert. Psyken er derimot subjektiv, flytende, flyktig og abstrakt, og derfor langt mer krevende å forske på. (aftenposten.no 26.1.2017).)

(Anm: Fem myter om schizofreni | Bjørn Rishovd Rund, professor, Psykologisk institutt, Universitetet i Oslo Fem myter om schizofreni. Begrepet schizofreni er sterkt belastet. Det skyldes til dels noen myter som er vanskelige å knekke. Bjørn Rishovd Rund professor, Psykologisk institutt, Universitetet i Oslo (aftenposten.no 5.2.2017).)

(Anm: Det vakreste mennesket jeg kjenner, har diagnosen schizofreni. Likevel kaller du ham gal | Karoline Kongshaug (aftenposten.no 29.6.2017).)

(Anm: Probiotics may help treat yeast infections, bowel problems in men with schizophrenia. The findings, published in the May 1 issue of Brain, Behavior, and Immunity, support growing evidence of close links between the mind and the gut. (…) The commercially available probiotic contained over 1 billion colony-forming units of Lactobacillus rhamnosus and Bifidobacterium animalis in each pill. PANSS scores were reassessed every two weeks, and the participants self-reported on the ease of their bowel movements weekly on a scale of 0 to 4. At the end of the study, the researchers collected another blood sample. Using the blood samples, the researchers measured antibody levels to yeast Saccharomyces cerevisiae, known as brewer's yeast, and Candida albicans, known to cause yeast infections, before and after the probiotic treatment. Both types of yeast are elevated in people with schizophrenia. (news-medical.net 5.4.2017).)  

(Anm: Bifidobacterium can mitigate intestinal immunopathology in the context of CTLA-4 blockade. Significance The major stumbling block in the use of checkpoint inhibitors for cancer treatment is the severe autoimmunity that often results. In this study, we found the toxicity of a checkpoint blockade antibody can be ameliorated via administration of Bifidobacterium, a widely available probiotic. These results suggest that it may be possible to mitigate the autoimmunity caused by anti–CTLA-4 and perhaps other checkpoint inhibitors by manipulating gut microbiota. PNAS (Proceedings of the National Academy of Sciences 2017 (published ahead of print December 18, 2017).)

(Anm: Psychosis: Link to brain inflammation antibodies raises new treatment hope. For the first time, researchers reveal that some people presenting with a first episode of psychosis have specific antibodies in their blood. The antibodies are the same ones known to cause encephalitis or brain inflammation. The discovery raises the question of whether the removal of these antibodies could be an effective treatment for psychosis as it is for encephalitis. The researchers - led by Belinda R. Lennox, a professor in the department of psychiatry at the University of Oxford in the United Kingdom - report their findings in The Lancet Psychiatry. (…) Previous studies have already fueled discussion about the role antibodies targeting neural proteins may play in psychosis. For example, a study reported in 2015 of children experiencing their first episode of psychosis, also found links to an antibody response to NMDAR. (medicalnewstoday.com 9.12.2016).)

(Anm: Psykose som målestokk for tvungent psykisk helsevern. Sammendrag Abstract  Denne artikkelen handlar om vilkåra for tvungent psykisk helsevern. Det er særleg fokusert på ei drøfting omkring det såkalla hovudvilkåret etter lov om psykisk helsevern (phvl.) § 3-3 (1) nr. 3. I artikkelen vert det drøfta om dagens rettsregel og dei vurderingstema den set opp, gjer ei god avgrensing sett i høve til føremåla med tvungent psykisk helsevern. Det vert òg skissert ei betre løysing for tolking av vilkåret. Kritisk juss03 / 2016 (Volum 2) Side: 217-237DOI: 10.18261/issn.2387-4546-2016-03-03.)

(Anm: Psykose forbundet med lave nivåer av fysisk aktivitet. (Psychosis associated with low levels of physical activity. A large international study of more than 200,000 people in nearly 50 countries has revealed that people with psychosis engage in low levels of physical activity, and men with psychosis are over two times more likely to miss global activity targets compared to people without the illness.) (medicalnewstoday.com 26.8.2016).)

Lithium-Like Drugs May Impair Neuronal Function
healthfinder.gov 21.12.2006
High doses in Alzheimer's patients may even kill nerve cells, researchers find

-- Too high a dose of lithium and other drugs that inhibit an enzyme called GSK-3 beta can impair, rather than improve, neurological function in patients with Alzheimer's disease and should be used with caution, a new study says.
Lithium is currently undergoing clinical trials as a treatment for Alzheimer's disease. It has been shown to be safe in treating people with manic depressive illness.

"People might think that if you make the inhibitor stronger and stronger, that would be better. Our in-vitro experiments show that you will have to be careful with how you use GSK-3 beta inhibitors, because if you use too much, it will interfere with and possibly kill neurons," study co-author Dr. William D. Snider, professor of neurology, cell and molecular physiology at the University of North Carolina at Chapel Hill's School of Medicine, said in a prepared statement. (...)

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