Department of Adult Psychiatry, Poznan University of Medical Sciences, 60-572 Poznan, Poland.
J Integr Neurosci. 2022 Mar 23;21(2):68. doi: 10.31083/j.jin2102068.
Currently, in psychiatry, lithium is a drug of choice as a mood stabilizer in the maintenance treatment of bipolar disorder for the prevention of manic and depressive recurrences. The second most important psychiatric use of lithium is probably increasing the efficacy of antidepressants in treatment-resistant depression. In addition to its mood-stabilizing properties, lithium exerts antisuicidal, antiviral, immunomodulatory, and neuroprotective effects. The goal of the review is to describe the experimental and clinical studies on the last three properties of lithium. Antiviral effects of lithium pertain mostly to DNA viruses, especially herpes viruses. The therapeutic effects of lithium in systemic and topical administration on labial and genital herpes were demonstrated in clinical studies. There is also some evidence, mostly in experimental studies, that lithium possesses antiviral activity against RNA viruses, including coronaviruses. The immunomodulatory effect of lithium can mitigate "low-grade inflammatory" conditions in bipolar illness. The neuroprotective properties of lithium make this ion a plausible candidate for the prevention and treatment of neurodegenerative disorders. A favorable effect of lithium was shown in experimental models of neurodegenerative disorders. On the clinical level, some preventive action against dementia and moderately therapeutic activity in Alzheimer's disease, and mild cognitive impairment were observed. Despite promising results of lithium obtained in animal models of Huntington's disease and amyotrophic lateral sclerosis, they have not been confirmed in clinical studies. A suggestion for common mechanisms of antiviral, immunomodulatory, and neuroprotective effects of lithium is advanced.
目前，在精神病学中，锂是双相情感障碍维持治疗中作为心境稳定剂的首选药物，可预防躁狂和抑郁复发。锂的第二大重要精神科用途可能是提高抗抑郁药治疗抵抗性抑郁症的疗效。除了稳定情绪的特性外，锂还具有抗自杀、抗病毒、免疫调节和神经保护作用。本综述的目的是描述锂的后三种特性的实验和临床研究。锂的抗病毒作用主要涉及 DNA 病毒，尤其是疱疹病毒。临床研究证明了锂在全身和局部给药治疗唇疱疹和生殖器疱疹方面的治疗效果。也有一些证据，主要是在实验研究中，表明锂对包括冠状病毒在内的 RNA 病毒具有抗病毒活性。锂的免疫调节作用可以减轻双相情感障碍中的“低度炎症”状态。锂的神经保护特性使这种离子成为预防和治疗神经退行性疾病的合理候选药物。锂在神经退行性疾病的实验模型中显示出了良好的效果。在临床水平上，观察到对痴呆症的预防作用以及对阿尔茨海默病和轻度认知障碍的适度治疗作用。尽管在亨廷顿病和肌萎缩侧索硬化症的动物模型中获得了锂的有希望的结果，但这些结果尚未在临床研究中得到证实。提出了锂的抗病毒、免疫调节和神经保护作用的共同机制的建议。
