Strawbridge Rebecca, Kerr-Gaffney Jess, Bessa Giulia, Loschi Giulia, Freitas Hanna Luísa O, Pires Hugo, Cousins David A, Juruena Mario F, Young Allan H
Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Neurosci Biobehav Rev. 2023 Jan;144:104975. doi: 10.1016/j.neubiorev.2022.104975. Epub 2022 Nov 24.
Lithium is widely evidenced for its neuropsychiatric benefits. Advantages of 'sub-therapeutic' doses are increasingly being reported, which is apposite given enduring concerns around adverse effects of 'therapeutic' doses. We aimed to synthesise all available evidence from interventional studies investigating low-dose lithium (LDL) across neuropsychiatric outcomes.
Electronic databases were systematically searched to include studies where a group of adult humans were treated with LDL (∼serum level ≤0.6 mmol/L), where data describing a neuropsychiatric outcome were reported either before and after treatment, and/or between lithium and a comparator.
18 articles were examined and grouped according to outcome domain (cognition, depression, mania, and related constructs e.g., suicidality). Significant benefits (versus placebo) were identified for attenuating cognitive decline, and potentially as an adjunctive therapy for people with depression/mania. Across studies, LDL was reported to be safe.
Despite the paucity and heterogeneity of studies, LDL's apparent pro-cognitive effects and positive safety profile open promising avenues in the fields of neurodegeneration, and augmentation in affective disorders. We urge future examinations of LDL's potential to prevent cognitive/affective syndromes.
锂盐对神经精神方面的益处有广泛证据支持。越来越多的报告指出“亚治疗剂量”的优势，鉴于人们一直对“治疗剂量”的不良反应有所担忧，这一点很恰当。我们旨在综合所有关于低剂量锂盐（LDL）对神经精神结局影响的干预性研究的现有证据。
系统检索电子数据库，纳入对一组成年人类使用LDL（~血清水平≤0.6 mmol/L）进行治疗的研究，这些研究需报告治疗前后及/或锂盐与对照之间描述神经精神结局的数据。
共审查18篇文章，并根据结局领域（认知、抑郁、躁狂及相关概念如自杀倾向）进行分组。发现LDL在减轻认知衰退方面有显著益处（与安慰剂相比），并且可能作为抑郁症/躁狂症患者的辅助治疗方法。在各项研究中，LDL均被报告为安全。
尽管研究数量不足且存在异质性，但LDL明显的促认知作用和良好的安全性在神经退行性疾病领域以及情感障碍增效治疗方面开辟了有前景的途径。我们敦促未来对LDL预防认知/情感综合征的潜力进行研究。
