Lithium citrate 509mg/5ml oral solution

BackgroundLithium, a mainstay treatment for bipolar disorders, has shown promise in treating cognitive impairments. However, concerns about cognition-related side effects persist.AimsWe aimed to synthesise the evidence on how lithium affects cognition by comparing cognitive performance before and after starting lithium treatment.MethodsA systematic search was conducted to identify studies examining lithium's effects on cognition. The review considered studies with adult human participants that reported quantitative cognitive outcomes using within-subject comparisons between lithium-absent and lithium-present conditions.ResultsThirty-two articles describing 30 studies were included (727 participants, approximately 54% female, mean age ± 50 years old). The studies exhibited significant heterogeneity within cognitive domains, including global cognition (15 studies), memory (19 studies), processing and psychomotor speed (8 studies), attention (9 studies), verbal fluency (4 studies) and executive function (6 studies). The included studies comprised 16 randomised controlled trials (RCTs) and 14 non-RCTs, with study populations ranging from individuals with affective disorders (13 studies) to neurocognitive disorders (11 studies) and healthy individuals (6 studies). Some studies reported cognitive enhancements, particularly in individuals with affective disorders, while others documented declines or mixed results.ConclusionsDefinitive conclusions regarding lithium's isolated cognitive effects remain elusive, particularly considering the influence of factors such as affective state, population and methodological heterogeneity among studies. Further research is needed to conclusively determine the raw cognitive impacts of lithium therapy, requiring larger RCTs across distinct populations. Prioritising the resolution of main symptoms should remain the primary therapeutic goal of lithium treatment.

Abstract licence: CC BY

The rapid design of advanced materials depends on synthesis parameters and design. A wide range of materials can be synthesized using precursor reactions based on chelated gel and organic polymeric gel pathways. The desire to develop high-performance lithium-ion rechargeable batteries has motivated decades of research on the synthesis of battery active material particles with precise control of composition, phase-purity, and morphology. Among the most common methods reported in the literature to prepare precursors for lithium-ion battery active materials, sol-gel is characterized by simplicity, homogeneous mixing, and tuning of the particle shape. The chelate gel and organic polymeric gel precursor-based sol-gel method is efficient to promote desirable reaction conditions. Both precursor routes are commonly used to synthesize lithium-ion battery cathode active materials from raw materials such as inorganic salts in aqueous solutions or organic solvents. The purpose of this review is to discuss synthesis procedure and summarize the progress that has been made in producing crystalline particles of tunable and complex morphologies by sol-gel synthesis that can be used as active materials for lithium-ion batteries.

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This review contains a compilation of data about the occurrence, mining, refining, and biological actions of lithium, without claiming completeness of knowledge. This should give a baseline for judging future pollutions of environmental and agricultural items and human nutrition and may show still existing gaps of screening. Emerging electromobility and use of computers leads to a steep increase in Li-based batteries, which are a source of hazardous waste unless recycled. Lack of recovery methods from effluents and sewage, however, will increase pollution with soluble Li-salts from increasing mining and waste in the future; therefore, biochemical effects of levels out of ambient range have been included. Many published data are hidden in multi-element tables, including the data of the author. Mobile fractions of soils and soil-to-plant transfer, as well as retainment in animal tissues, are low. A lot of data, starting from geology via soils, plants, water, and human nutrition, lead to a largely unknown average daily intake for men. With respect to nutrition of dairy cows, the contribution of Li from water was highest among all elements investigated, but only 4% of intake. Main sources for human nutrition are mineral water and table salt. Li is not labelled on mineral water bottles, nor table salt, which are the main sources. Though some data have been gathered, for human nutrition, the average daily intake is uncertain to estimate because some mineral waters are quite high in Li.

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BackgroundLithium carbonate has a narrow therapeutic index, and postoperative anatomical/physiological changes after bariatric surgery may markedly alter its pharmacokinetics.CaseA 25-year-old woman with bipolar disorder on long-term lithium therapy developed altered consciousness and profound sinus bradycardia (nadir 27 bpm) approximately 7 weeks after single-incision laparoscopic sleeve gastrectomy. Laboratory testing revealed hyponatremia, acute kidney injury, and a serum lithium level of 4.16 mmol/L.Interventions and outcomesLithium and other psychotropics were discontinued, fluid resuscitation and inotropic support were initiated, and three consecutive sessions of continuous renal replacement therapy (CRRT) were performed. Serum lithium normalized without rebound, Sinus bradycardia recovered, and the patient was discharged without pacemaker implantation. During follow-up, lithium was permanently discontinued and replaced with lamotrigine. Mood remained stable without cardiac or neurologic sequelae.ConclusionPost-bariatric patients receiving lithium should be considered high risk for intoxication. Routine monitoring with early recognition and multidisciplinary collaboration is essential to prevent complications. This case further shows that even extreme lithium-induced bradycardia can be fully reversible with timely withdrawal and extracorporeal clearance, highlighting the need to address reversible causes before permanent pacing.

Abstract licence: CC BY