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.