Pharmacoepidemiology and Clinical Correlates of Lithium Treatment for Bipolar Disorder in Asia

Shuy YK 1 , Santharan S 2 , Chew QH 3 , Lin SK , Ouyang WC , Chen CK 4 Show all authors , Park SC , Jang OJ 5 , Park JH 6 , Chee KY 7 , Ding KS 8 , Chong J 9 , Zhang L 10 , Li K 11 , Zhu X 12 , Jatchavala C 13 , Pariwatcharakul P 14 , Kallivayalil RA 15 , Grover S 16 , Avasthi A 16 , Ansari M 17 , Maramis MM 18 , Aung PP 19 , Tan CH 20 , Xiang YT , Chong MY 21 , Park YC 22 , Kato TA 23 , Shinfuku N 24 , Baldessarini RJ , Sim K 25

Affiliations 

  • 1 Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
  • 2 Department of Emergency and Crisis Care, Institute of Mental Health, Singapore
  • 3 Research Division, Institute of Mental Health, Singapore
  • 4 Chang Gung Memorial Hospital, Keelung Branch, Keelung, Taiwan
  • 5 Department of Psychiatry, Bugok National Hospital, Changnyong, South Korea
  • 6 Jeju National University Hospital, Jeju University School of Medicine, Jeju, South Korea
  • 7 Department of Psychiatry and Mental Health, Tunku Abdul Rahman Institute of Neurosciences, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia
  • 8 Department of Psychiatry, Hospital Bahagia Ulu Kinta, Tanjung Rambutan, Perak Darul Ridzwan, Malasia
  • 9 Hospital Permai Johor Bahru, Ministry of Health, Johor Bahru, Malaysia
  • 10 The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, School of Mental Health, Capital Medical University, Beijing, China
  • 11 Hebei Provincial Mental Health Center, Baoding, Hebei, China
  • 12 Department of Psychiatry, Suzhou Guangji Hospital, the Affiliated Guangji Hospital of Soochow University, Suzhou, China
  • 13 Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
  • 14 Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • 15 Department of Psychiatry, Pushpagiri Institute of Medical Sciences, Tiruvalla, India
  • 16 Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
  • 17 Department of Psychiatry, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
  • 18 Department of Psychiatry, Dr Soetomo Hospital-Faculty of Medicine, Airlangga University, Surabaya, Indonesia
  • 19 Mental Health Hospital, Yangon University of Medicine, Yangon, Myanmar
  • 20 Department of Pharmacology, National University of Singapore, Singapore
  • 21 Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and School of Medicine, Chang Gung University, Taoyuan City, Taiwan
  • 22 Department of Neuropsychiatry, Hanyang University Guri Hospital, Guri, South Korea
  • 23 Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University Fukuoka, Japan
  • 24 School of Human Sciences, Seinan Gakuin University, Fukuoka, Japan
  • 25 West Region, Institute of Mental Health, Singapore
J Clin Psychopharmacol, 2024 01 16;44(2):117-123.
PMID: 38230861 DOI: 10.1097/JCP.0000000000001813

Abstract

BACKGROUND: As clinical practices with lithium salts for patients diagnosed with bipolar disorder (BD) are poorly documented in Asia, we studied the prevalence and clinical correlates of lithium use there to support international comparisons.

METHODS: We conducted a cross-sectional study of use and dosing of lithium salts for BD patients across 13 Asian sites and evaluated bivariate relationships of lithium treatment with clinical correlates followed by multivariate logistic regression modeling.

RESULTS: In a total of 2139 BD participants (52.3% women) of mean age 42.4 years, lithium salts were prescribed in 27.3% of cases overall, varying among regions from 3.20% to 59.5%. Associated with lithium treatment were male sex, presence of euthymia or mild depression, and a history of seasonal mood change. Other mood stabilizers usually were given with lithium, often at relatively high doses. Lithium use was associated with newly emerging and dose-dependent risk of tremors as well as risk of hypothyroidism. We found no significant differences in rates of clinical remission or of suicidal behavior if treatment included lithium or not.

CONCLUSIONS: Study findings clarify current prevalence, dosing, and clinical correlates of lithium treatment for BD in Asia. This information should support clinical decision-making regarding treatment of BD patients and international comparisons of therapeutic practices.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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