Question: What is the evidence for long-term lithium use as a cause of cognitive problems in older adults?

Answer:

No definite clinical implications can be made based on the available evidence. More studies are needed to assess the impact of

long-term lithium on cognitive outcomes/problems in older adults. Only one study met the inclusion criteria for this BEST summary, which found no relationship between duration of lithium use and cognitive function. The methodology employed by this study, however, reduces the reliability of these findings. The authors suggested that "…a possible next step in the evaluation of the benefits of lithium treatment on brain health, [is] a short-term (one-year) prospective randomised controlled trial of add-on lithium versus placebo in older adults with BD who have had minimal recent lithium exposure, evaluating both cognitive and brain imaging outcomes as well as measuring biomarkers..". The authors then suggested that this be followed-up with a long-term study, depending on the outcomes.