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Lithium’s impact on proinflammatory cytokines in patients withbipolar disorder, schizophrenia and major depressive disorder:a systematic literature review.
Örebro University, School of Medical Sciences.
2019 (English)Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
Abstract [en]

Background: Psychiatric diseases such as bipolar disorder, major depressive disorder (MDD)and schizophrenia are chronic ailments that severely affect daily function and quality of life. A relationship between elevated levels of proinflammatory cytokines and these disorders hasbeen suggested in several studies. Lithium is used as a treatment in bipolar disorder, and as anadjunctive treatment in MDD and schizophrenia. Despite the extensive use of lithium, it’smechanism of action is not fully understood. One of the proposed hypotheses of lithium’smechanism of action is reduction in the levels of proinflammatory cytokines.

Aim: The aim of this systematic literature review is to describe the effects of lithium onproinflammatory cytokines (IL-1, IL-6, INF- γ, TNF) in bipolar disorder, MDD andschizophrenia.

Methods: The study was conducted through a search in the electronic database PubMed.Using the PICOS format, inclusion and exclusion criteria were specified. Search words andfilters were combined using both Medical Subject Headings (MeSH) terms and free textsearch words. The search initially resulted in 105 articles and through inclusion and exclusioncriteria full-text articles were estimated for eligibility. Risk of bias was estimated using theCochrane Handbook.

Results: A total of 10 eligible articlets were included in this study. Nine out of 10 articlesinvestigated bipolar patients, and one article investigated patients with MDD. No article investigated patients with schizophrenia. Four out of 9 articles regarding bipolar patientsreported a significant decrease in some proinflammatory cytokines after lithiumtreatment, 4 articles reported a significant increase, and one article reported no change in theproinflammatory cytokines. In two well conducted studies where bipolar disorder wasinvestigated, lithium had differential effects, namely decreasing proinflammatory cytokines inlithium responders compared to lithium non-responders. No significant change inproinflammatory cytokine levels after lithium treatment were found in the article studyingMDD patients.

Conclusions: The results indicated that lithium may have different effects depending onwhich specific cytokine was studied and on the specific characteristics of the studiedpopulation. Therefore, the outcomes of our review cannot unequivocally answer whetherlithium acts by increasing or decreasing proinflammatory cytokines, or both depending on theexperimental conditions. Further research is needed to fully elucidate the relationship betweenlithium and proinflammatory cytokines in bipolar disorder, MDD and schizophrenia.

Place, publisher, year, edition, pages
2019.
Keywords [en]
Lithium, Bipolar disorder, MDD, Schizophrenia, Proinflammatory Cytokines
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:oru:diva-73977OAI: oai:DiVA.org:oru-73977DiVA, id: diva2:1308116
Subject / course
Medicine
Supervisors
Examiners
Available from: 2019-04-30 Created: 2019-04-30 Last updated: 2019-04-30Bibliographically approved

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