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Lithium treatment and mechanisms of aging

Molecular Psychiatry volume 23, pages 2112–2113 (2018)Cite this article

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Lithium—a light metal named after the Greek word “lithos,” meaning “stone”—has been extensively used, in various salt forms, in the treatment of mood disorders for over half a century. During this stretch of time, a large body of evidence has demonstrated its efficacy and effectiveness, most notably when used as prophylactic treatment for bipolar disorder and as augmentation agent for treatment-refractory unipolar depression. The powerful mood-stabilizing properties of the drug have sustained its front-line use for the management of affective disorders, despite the emergence of newer mood stabilizers with favorable side effect profiles.

While the benefits of lithium on mood stabilization have been long documented, studies more recently identified a notable property of the drug: its ability to extend survival. This was initially ascribed to lithium’s role in preventing affective recurrences and decreasing suicide risk. However, several observations suggest that it may influence mortality through additional mechanisms. First, the pro-survival effect of lithium has been observed independent of its impact on mood stabilization or recurrence prevention [1]. Second, lithium more strongly reduces mortality than other mood stabilizers [2, 3], suggesting that certain of its beneficial effects are not shared by other compounds. Third, lithium has been shown to reduce not only suicide mortality but also non-suicide, cardiovascular, and all-cause mortality [2,3,4,5]. The mechanisms underlying these intriguing observations are poorly understood.

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Acknowledgements

The author would like to express his gratitude to Dr. Grace Thrall, whose dedicated teaching was an inspiration for this article.

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  1. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA

    Anthony S. Zannas

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Correspondence to Anthony S. Zannas.

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Zannas, A.S. Lithium treatment and mechanisms of aging. Mol Psychiatry 23, 2112–2113 (2018). https://doi.org/10.1038/s41380-018-0024-6

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