Niveles séricos de litio y aparición de efectos adversos durante la fase de mantenimiento en el tratamiento de trastorno afectivo bipolar: una revisión sistemática

ilustraciones, diagramas,

Autores:: Rico Castrellón, Carlos Guillermo

Tipo de recurso:

Fecha de publicación:: 2023

Institución:: Universidad Nacional de Colombia

Repositorio:: Universidad Nacional de Colombia

Idioma:: spa

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dc.title.spa.fl_str_mv	Niveles séricos de litio y aparición de efectos adversos durante la fase de mantenimiento en el tratamiento de trastorno afectivo bipolar: una revisión sistemática
dc.title.translated.eng.fl_str_mv	Serum lithium levels and occurrence of adverse effects during the maintenance phase in the treatment of bipolar affective disorder: a systematic review
title	Niveles séricos de litio y aparición de efectos adversos durante la fase de mantenimiento en el tratamiento de trastorno afectivo bipolar: una revisión sistemática
spellingShingle	Niveles séricos de litio y aparición de efectos adversos durante la fase de mantenimiento en el tratamiento de trastorno afectivo bipolar: una revisión sistemática 610 - Medicina y salud::615 - Farmacología y terapéutica 610 - Medicina y salud::616 - Enfermedades Psicofarmacología Psychopharmacology Transtorno bipolar Bipolar Disorder Trastorno bipolar Litio Niveles séricos Tratamiento de mantenimiento Efectos adversos Bipolar disorder Lithium Serum levels Maintenance treatment Adverse effects
title_short	Niveles séricos de litio y aparición de efectos adversos durante la fase de mantenimiento en el tratamiento de trastorno afectivo bipolar: una revisión sistemática
title_full	Niveles séricos de litio y aparición de efectos adversos durante la fase de mantenimiento en el tratamiento de trastorno afectivo bipolar: una revisión sistemática
title_fullStr	Niveles séricos de litio y aparición de efectos adversos durante la fase de mantenimiento en el tratamiento de trastorno afectivo bipolar: una revisión sistemática
title_full_unstemmed	Niveles séricos de litio y aparición de efectos adversos durante la fase de mantenimiento en el tratamiento de trastorno afectivo bipolar: una revisión sistemática
title_sort	Niveles séricos de litio y aparición de efectos adversos durante la fase de mantenimiento en el tratamiento de trastorno afectivo bipolar: una revisión sistemática
dc.creator.fl_str_mv	Rico Castrellón, Carlos Guillermo
dc.contributor.advisor.none.fl_str_mv	Jaramillo González, Luis Eduardo
dc.contributor.author.none.fl_str_mv	Rico Castrellón, Carlos Guillermo
dc.contributor.researcher.none.fl_str_mv	Vallejo Ortega María Teresa
dc.subject.ddc.spa.fl_str_mv	610 - Medicina y salud::615 - Farmacología y terapéutica 610 - Medicina y salud::616 - Enfermedades
topic	610 - Medicina y salud::615 - Farmacología y terapéutica 610 - Medicina y salud::616 - Enfermedades Psicofarmacología Psychopharmacology Transtorno bipolar Bipolar Disorder Trastorno bipolar Litio Niveles séricos Tratamiento de mantenimiento Efectos adversos Bipolar disorder Lithium Serum levels Maintenance treatment Adverse effects
dc.subject.decs.spaeng.fl_str_mv	Psicofarmacología
dc.subject.decs.spa.fl_str_mv	Psychopharmacology Transtorno bipolar
dc.subject.decs.eng.fl_str_mv	Bipolar Disorder
dc.subject.proposal.spa.fl_str_mv	Trastorno bipolar Litio Niveles séricos Tratamiento de mantenimiento Efectos adversos
dc.subject.proposal.eng.fl_str_mv	Bipolar disorder Lithium Serum levels Maintenance treatment Adverse effects
description	ilustraciones, diagramas,
publishDate	2023
dc.date.issued.none.fl_str_mv	2023
dc.date.accessioned.none.fl_str_mv	2024-01-29T20:53:13Z
dc.date.available.none.fl_str_mv	2024-01-29T20:53:13Z
dc.type.spa.fl_str_mv	Trabajo de grado - Especialidad Médica
dc.type.driver.spa.fl_str_mv	info:eu-repo/semantics/masterThesis
dc.type.version.spa.fl_str_mv	info:eu-repo/semantics/acceptedVersion
dc.type.content.spa.fl_str_mv	Text
dc.type.redcol.spa.fl_str_mv	http://purl.org/redcol/resource_type/TM
status_str	acceptedVersion
dc.identifier.uri.none.fl_str_mv	https://repositorio.unal.edu.co/handle/unal/85502
dc.identifier.instname.spa.fl_str_mv	Universidad Nacional de Colombia
dc.identifier.reponame.spa.fl_str_mv	Repositorio Institucional Universidad Nacional de Colombia
dc.identifier.repourl.spa.fl_str_mv	https://repositorio.unal.edu.co/
url	https://repositorio.unal.edu.co/handle/unal/85502 https://repositorio.unal.edu.co/
identifier_str_mv	Universidad Nacional de Colombia Repositorio Institucional Universidad Nacional de Colombia
dc.language.iso.spa.fl_str_mv	spa
language	spa
dc.relation.references.spa.fl_str_mv	Vieta, E., Berk, M., Schulze, T. et al. bipolar disorders. Nat Rev Dis Primers. 2018:4; 18008. Vigo, D., Thornicroft, G. & Atun, R. Estimating the true global burden of mental illness. Lancet Psychiatry. 2016:3;171–178. Bessonova L, Ogden K, Doane MJ, O'Sullivan AK, Tohen M. The Economic Burden of Bipolar Disorder in the United States: A Systematic Literature Review. Clinicoecon Outcomes Res. 2020; 12:481-497. Simon J, Pari AAA, Wolstenholme J, Berger M, Goodwin GM, Geddes JR. The costs of bipolar disorder in the United Kingdom. Brain Behav. 2021;11(10): e2351. American Psychiatric Association. Practice guideline for the treatment of patients with bipolar disorder (revision). Am J Psychiatry. 2002;159(4 Suppl):1-50. Goodwin GM, Haddad PM, Ferrier IN, et al. Evidence-based guidelines for treating bipolar disorder: Revised third edition recommendations from the British Association for Psychopharmacology. J Psychopharmacol. 2016;30(6):495-553. Yatham LN, Kennedy SH, Parikh SV, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder. Bipolar Disord. 2018;20(2):97-170. Malhi GS, Bell E, Bassett D, et al. The 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders. Aust N Z J Psychiatry. 2021;55(1):7-117. National Collaborating Centre for Mental Health (UK). Bipolar Disorder: The NICE Guideline on the Assessment and Management of Bipolar Disorder in Adults, Children and Young People in Primary and Secondary Care. London: The British Psychological Society and The Royal College of Psychiatrists; September 2014. Fountoulakis KN, Grunze H, Vieta E, et al. The International College of Neuro-Psychopharmacology (CINP) Treatment Guidelines for Bipolar Disorder in Adults (CINP-BD-2017), Part 3: The Clinical Guidelines. Int J Neuropsychopharmacol. 2017;20(2):180-195. Del Matto L, Muscas M, Murru A, et al. Lithium and suicide prevention in mood disorders and in the general population: A systematic review. Neurosci Biobehav Rev. 2020; 116:142-153. Cipriani A, Hawton K, Stockton S, Geddes JR. Lithium in the prevention of suicide in mood disorders: updated systematic review and meta-analysis. BMJ. 2013;346: f3646. Araya P, Martínez C, Barros J. Lithium in Drinking Water as a Public Policy for Suicide Prevention: Relevance and Considerations. Front Public Health. 2022. Won E, Kim YK. An Oldie but Goodie: Lithium in the Treatment of Bipolar Disorder through Neuroprotective and Neurotrophic Mechanisms. Int J Mol Sci. 2017;18(12):2679. Ochoa ELM. Lithium as a Neuroprotective Agent for Bipolar Disorder: An Overview. Cell Mol Neurobiol. 2022;42(1):85-97. Severus WE, Kleindienst N, Seemüller F, Frangou S, Möller HJ, Greil W. What is the optimal serum lithium level in the long-term treatment of bipolar disorder--a review? Bipolar Disord. 2008;10(2):231-237. Nolen WA, Licht RW, Young AH, et al. What is the optimal serum level for lithium in the maintenance treatment of bipolar disorder? A systematic review and recommendations from the ISBD/IGSLI Task Force on treatment with lithium. Bipolar Disord. 2019;21(5):394-409. Hsu CW, Carvalho AF, Tsai SY, et al. Lithium concentration and recurrence risk during maintenance treatment of bipolar disorder: Multicenter cohort and meta-analysis. Acta Psychiatr Scand. 2021;144(4):368-378. Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. The Cochrane Collaboration, 2011. Bendz H, Aurell M, Balldin J, et al. Kidney damage in long-term lithium patients: a cross-sectional study of patients with 15 years or more on lithium. Nephrol Dial Transplant. 1994;9: 1250–1254. Fairbrother F, Petzl N, Scott JG, Kisely S. Lithium can cause hyperthyroidism as well as hypothyroidism: A systematic review of an under-recognised association. Aust N Z J Psychiatry. 2019;53(5):384-402. Schoot TS, Molmans THJ, Grootens KP, Kerckhoffs APM. Systematic review and practical guideline for the prevention and management of the renal side effects of lithium therapy. Eur Neuropsychopharmacol. 2020; 31:16-32. Taylor D, Barnes T, Young A. Bipolar Disorder. En: The Maudsley Prescribing Guidelines in Psychiatry. Fourteenth Edition. Wiley Blackwell. 2018; p. 247-304. Nolen WA, Weisler RH. The association of the effect of lithium in the maintenance treatment of bipolar disorder with lithium plasma levels: a post hoc analysis of a double-blind study comparing switching to lithium or placebo in patients who responded to quetiapine (Trial 144). Bipolar Disord. 2013;15(1):100-109. Kessing LV, Vradi E, Andersen PK. Nationwide and population-based prescription patterns in bipolar disorder. Bipolar Disord. 2016;18(2):174-182. Hooshmand F, Miller S, Dore J, et al. Trends in pharmacotherapy in patients referred to a bipolar specialty clinic, 2000-2011. J Affect Disord. 2014; 155:283-287. Jawad I, Watson S, Haddad PM, Talbot PS, McAllister-Williams RH. Medication nonadherence in bipolar disorder: a narrative review. Ther Adv Psychopharmacol. 2018; 16;8(12):349-363. Mago R, Borra D, Mahajan R. Role of adverse effects in medication nonadherence in bipolar disorder. Harv Rev Psychiatry. 2014 Nov-Dec;22(6):363-6. Öhlund L, Ott M, Oja S, Bergqvist M, Lundqvist R, Sandlund M, Salander Renberg E, Werneke U. Reasons for lithium discontinuation in men and women with bipolar disorder: a retrospective cohort study. BMC Psychiatry. 2018 Feb 7;18(1):37. Malhi GS, Berk M. Is the safety of lithium no longer in the balance? Lancet. 2012;379(9817):690-692. Young W. Review of lithium effects on brain and blood. Cell Transplant. 2009;18(9):951-75. Lang EJ, Davis SM. Lithium neurotoxicity: the development of irreversible neurological impairment despite standard monitoring of serum lithium levels. J Clin Neurosci. 2002 May;9(3):308-9. Gitlin MJ. Lithium: serum levels, renal effects, and dosing strategies. Community Ment Health J. 1992 Aug;28(4):355-62. McKnight RF, Adida M, Budge K, Stockton S, Goodwin GM, Geddes JR. Lithium toxicity profile: a systematic review and meta-analysis. Lancet. 2012;379(9817):721-728. Shine B, McKnight RF, Leaver L, Geddes JR. Long-term effects of lithium on renal, thyroid, and parathyroid function: a retrospective analysis of laboratory data. Lancet. 2015;386(9992):461-468. Gitlin M. Lithium side effects and toxicity: prevalence and management strategies. Int J Bipolar Disord. 2016 Dec;4(1):27. Boton R, Gaviria M, Batlle DC. Prevalence, pathogenesis, and treatment of renal dysfunction associated with chronic lithium therapy. Am J Kidney Dis 1987; 10:329–45. Marples D, Christensen S, Christensen EI, Ottosen PD, Nielsen S. Lithium-induced downregulation of Aquaporin-2 water channel expression in rat kidney medulla. J Clin Invest 1995; 95:1838–45. Paul R, Minay J, Cardwell C, Fogarty D, Kelly C. Review: Meta-analysis of the effects of lithium usage on serum creatinine levels. Journal of Psychopharmacology. 2010;24(10):1425-1431. Łukawska E, Frankiewicz D, Izak M, Woźniak A, Dworacki G, Niemir ZI. Lithium toxicity and the kidney with special focus on nephrotic syndrome associated with the acute kidney injury: A case-based systematic analysis. J Appl Toxicol. 2021;41(12):1896-1909. Bendz H, Aurell M, Balldin J, Mathé AA, Sjödin I. Kidney damage in long-term lithium patients: a cross-sectional study of patients with 15 years or more on lithium. Nephrol Dial Transplant. 1994;9(9):1250-1254. Bendz H, Aurell M, Lanke J. A historical cohort study of kidney damage in long-term lithium patients: continued surveillance needed. Eur Psychiatry. 2001;16(4):199-206. Van Melick EJ, Meinders A, Hoffman T, Egberts T. Renal effects of long-term lithium therapy in the elderly: a cross-sectional study. Int. J. Geriatr. Psychiatry. 2008;23(3):685-692. Scherf-Clavel M, Treiber S, Deckert J, Unterecker S, Hommers L. Drug-Drug Interactions Between Lithium and Cardiovascular as Well as Anti-Inflammatory Drugs. Pharmacopsychiatry. 2020;53(5):229-234. Vendsborg PB, Bech P, Rafaelsen OJ. Lithium treatment and weight gain. Acta Psychiatr Scand 1976; 53:139–47. e Haack S, Seeringer A, Thürmann PA, Becker T, Kirchheiner J. Sex-specific differences in side effects of psychotropic drugs: genes or gender? Pharmacogenomics. 2009;10(9):1511-1526. Teixeira NA, Karniol IG. The influence of age and sex on weight variation in rats treated chronically with lithium chloride. Acta Pharmacol Toxicol (Copenh) 1982; 51:1–5.37. Sussman N, Ginsberg D. Effects of psychotropic drugs on weight. Psychiatr Ann 1999; 29:580–94. Brady KT. Weight gain associated with psychotropic drugs. South Med J 1989; 82:611–7. Vendsborg PB, Rafaelsen OJ. Lithium in man: effect on glucose tolerance and serum electrolytes. Acta Psychiatr Scand 1973; 49:601–10. Vendsborg PB, Prytz S. Glucose tolerance and serum lipids in man after long-term lithium administration. Acta Psychiatr Scand 1976; 53:64–9. Livingstone C, Rampes H. Lithium: a review of its adverse metabolic effects. J Psychopharmacol 2006; 20:347–55. Johnston AM, Eagles JM. Lithium-associated clinical hypothyroidism. Prevalence and risk factors. Br J Psychiatry 1999; 175:336–9. Henry C. Lithium side-effects and predictors of hypothyroidism in patients with bipolar disorder: sex differences. J Psychiatry Neurosci 2002; 27:104–7. Kirov G, Tredget J, John R, Owen MJ, Lazarus JH. A cross-sectional and a prospective study of thyroid disorders in lithium-treated patients. J Affect Disord. 2005;87(2-3):313-317. Miller KK, Daniels GH. Association between lithium use and thyrotoxicosis caused by silent thyroiditis. Clin Endocrinol (Oxf). 2001;55(4):501-508. Haden ST, Stoll AL, McCormick S, Scott J, Fuleihan G. el-H Alterations in parathyroid dynamics in lithium-treated subjects. J Clin Endocrinol Metab 1997; 82:2844. Bucht G, Smigan L, Wahlin A, Eriksson P. ECG changes during lithium therapy. A prospective study. Acta Med Scand. 1984;216(1):101-4. Mehta N, Vannozzi R. Lithium-induced electrocardiographic changes: A complete review. Clin Cardiol. 2017;40(12):1363-1367. Bowden CL. Acute and maintenance treatment with mood stabilizers. Int J Neuropsychopharmacol 2003; 6:269-75. Gelenberg AJ JJ. Lithium tremor. J Clin Psychiatry 1995; 56:283–7. Dols A, Sienaert P, Gerven H Van, Schouws S, Stevens A, Kupka R, et al. The prevalence and management of side effects of lithium and anticonvulsants as mood stabilisers in bipolar disorder from a clinical perspective: a review. Int Clin Psychopharmacol 2013; 28:287-96. Boltan DD, Fenves AZ. Effectiveness of normal saline diuresis in treating lithium overdose. Proc (Bayl Univ Med Cent). 2008 Jul;21(3):261-3. Dunne FJ. Lithium toxicity: the importance of clinical signs. Br J Hosp Med. 2010 Apr;71(4):206-10. Cuigniez M, Audenaert K, Santens P, Heylens G. SILENT: The syndrome of irreversible lithium-effectuated neurotoxicity: A case report with two years follow-up. Clin Neurol Neurosurg. 2020; 195:106057. Yeung CK, Chan HHL. Cutaneous adverse effects of lithium: epidemiology and management. Am J Clin Dermatol 2004; 5:3–8. Nora JJ, Nora AH, Toews WH. Letter: lithium, Ebstein’s anomaly, and other congenital heart defects. Lancet. 1974; 2:594–595. Munk-Olsen T, Liu X, Viktorin A, et al. Maternal and infant outcomes associated with lithium use in pregnancy: an international collaborative meta-analysis of six cohort studies. Lancet Psychiatry. 2018;5(8):644-652. Giles JJ, Bannigan JG. Teratogenic and developmental effects of lithium. Curr Pharm Des. 2006;12(12):1531-1541. GA Wells, B Shea, D O'Connell, J Peterson, V Welch, M Losos, P Tugwell. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses [Internet]. Ottawa Hospital Research Institute. 2020 [consultado el 13 de octubre de 2023]. Disponible en: http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp. Sterne JAC, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, Cates CJ, Cheng H-Y, Corbett MS, Eldridge SM, Hernán MA, Hopewell S, Hróbjartsson A, Junqueira DR, Jüni P, Kirkham JJ, Lasserson T, Li T, McAleenan A, Reeves BC, Shepperd S, Shrier I, Stewart LA, Tilling K, White IR, Whiting PF, Higgins JPT. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ 2019; 366: l4898. Page C, Benaim S, Lappin F. A long-term retrospective follow-up study of patients treated with prophylactic lithium carbonate. Br J Psychiatry. 1987 Feb; 150:175-9. Vestergaard P, Licht RW, Brodersen A, Rasmussen NA, Christensen H, Arngrim T, Grønvall B, Kristensen E, Poulstrup I. Outcome of lithium prophylaxis: a prospective follow-up of affective disorder patients assigned to high and low serum lithium levels. Acta Psychiatr Scand. 1998 Oct;98(4):310-5. Wilting I, Heerdink ER, Mersch PP, den Boer JA, Egberts AC, Nolen WA. Association between lithium serum level, mood state, and patient-reported adverse drug reactions during long-term lithium treatment: a naturalistic follow-up study. Bipolar Disord. 2009 Jun;11(4):434-40. Van Alphen AM, Bosch TM, Kupka RW, Hoekstra R. Chronic kidney disease in lithium-treated patients, incidence and rate of decline. Int J Bipolar Disord. 2021 Jan 4;9(1):1. Gelenberg AJ, Kane JM, Keller MB, Lavori P, Rosenbaum JF, Cole K, Lavelle J. Comparison of standard and low serum levels of lithium for maintenance treatment of bipolar disorder. N Engl J Med. 1989 Nov 30;321(22):1489-93. Peselow ED, Dunner DL, Fieve RR, Rubinstein ME. Course and relationship of lithium side effects to plasma lithium levels. Psychiatr Clin (Basel). 1981;14(3):178-83. Bucht G, Smigan L, Wahlin A, Eriksson P. ECG changes during lithium therapy. A prospective study. Acta Med Scand. 1984;216(1):101-4. Dineen R, Bogdanet D, Thompson D, Thompson CJ, Behan LA, McKay AP, Boran G, Wall C, Gibney J, O'Keane V, Sherlock M. Endocrinopathies and renal outcomes in lithium therapy: impact of lithium toxicity. QJM. 2017 Dec 1;110(12):821-827. Boivin E, Le Daré B, Bellay R, Vigneau C, Mercerolle M, Bacle A. Long-term lithium therapy and risk of chronic kidney disease, hyperparathyroidism and hypercalcemia: a cohort study. Int J Bipolar Disord. 2023 Jan 29;11(1):4. Maj M, Starace F, Nolfe G, Kemali D. Minimum plasma lithium levels required for effective prophylaxis in DSM III bipolar disorder: a prospective study. Pharmacopsychiatry. 1986 Nov;19(6):420-3. Schou M, Vestergaard P. Prospective studies on a lithium cohort. 2. Renal function. Water and electrolyte metabolism. Acta Psychiatr Scand. 1988 Oct;78(4):427-33. Vestergaard P, Poulstrup I, Schou M. Prospective studies on a lithium cohort. 3. Tremor, weight gain, diarrhea, psychological complaints. Acta Psychiatr Scand. 1988 Oct;78(4):434-41. DePaulo JR Jr, Correa EI, Sapir DG. Renal function and lithium: a longitudinal study. Am J Psychiatry. 1986 Jul;143(7):892-5. Bauer M, Blumentritt H, Finke R, Schlattmann P, Adli M, Baethge C, Bschor T, Müller-Oerlinghausen B, Berghöfer A. Using ultrasonography to determine thyroid size and prevalence of goiter in lithium-treated patients with affective disorders. J Affect Disord. 2007 Dec;104(1-3):45-51. Bocchetta A, Ardau R, Carta P, Ligas F, Sardu C, Pani A, et al. Duration of lithium treatment is a risk factor for reduced glomerular function: a cross-sectional study. BMC Med. 2013; 11:33. Davis J, Desmond M, Berk M. Lithium and nephrotoxicity: a literature review of approaches to clinical management and risk stratifcation. BMC Nephrol. 2018;19(1):305. Kirkham E, Skinner J, Anderson T, Bazire S, Twigg MJ, Desborough JA. One lithium level >1.0 mmol/L causes an acute decline in eGFR: findings from a retrospective analysis of a monitoring database. BMJ Open. 2014 Nov 7;4(11): e006020. Greil W, de Bardeci M, Müller-Oerlinghausen B, Nievergelt N, Stassen H, Hasler G, Erfurth A, Cattapan K, Rüther E, Seifert J, Toto S, Bleich S, Schoretsanitis G. Controversies regarding lithium-associated weight gain: case-control study of real-world drug safety data. Int J Bipolar Disord. 2023 Oct 15;11(1):34. Ambrosiani L, Pisanu C, Deidda A, Chillotti C, Stochino ME, Bocchetta A. Thyroid and renal tumors in patients treated with long-term lithium: case series from a lithium clinic, review of the literature and international pharmacovigilance reports. Int J Bipolar Disord. 2018 Aug 6;6(1):17. Naranjo CA, Busto U, Sellers EM, Sandor P, Ruiz I, Roberts EA, Janecek E, Domecq C, Greenblatt DJ. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther. 1981 Aug;30(2):239-45.
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spelling	Reconocimiento 4.0 Internacionalhttp://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Jaramillo González, Luis Eduardo4769b952956ef042d183fc05c4a58713Rico Castrellón, Carlos Guillermoe4ac68e26b05433c992712e6b8e9a9efVallejo Ortega María Teresa2024-01-29T20:53:13Z2024-01-29T20:53:13Z2023https://repositorio.unal.edu.co/handle/unal/85502Universidad Nacional de ColombiaRepositorio Institucional Universidad Nacional de Colombiahttps://repositorio.unal.edu.co/ilustraciones, diagramas,Niveles séricos de litio y aparición de efectos adversos durante la fase de mantenimiento en el tratamiento de trastorno afectivo bipolar: una revisión sistemática Introducción. El trastorno bipolar (TB) es una enfermedad crónica que cursa con periodos de recaída y remisión que tienen un impacto significativo a nivel de morbimortalidad y de salud pública. Desde el auge de la psicofarmacología y el desarrollo psicofármacos se ha disminuido las tasas de recaída y el impacto a nivel de morbimortalidad de los pacientes, y si bien el arsenal terapéutico ha aumentado, el litio sigue siendo el tratamiento de elección en la gran mayoría de guías de práctica clínica desarrolladas para el tratamiento de esta enfermedad. Sin embargo, su prescripción ha venido disminuyendo en parte como consecuencia de su perfil de seguridad. Si bien los efectos adversos y la toxicidad del litio son frecuente motivo de estudio y son bien conocidos, no hay evidencia precisa respecto al riesgo de aparición de estos dependiendo de los niveles séricos de litio aún en dosis terapéuticas. Objetivo. Evaluar el rol pronóstico de los niveles séricos de litio en la aparición de efectos adversos en pacientes con trastorno afectivo bipolar en fase de mantenimiento. Métodos. Se llevó a cabo una revisión sistemática de la literatura en múltiples bases de datos incluyendo estudios de carácter observacional longitudinal y experimental en los que se hizo seguimiento a los niveles séricos de litio de los participantes, y en los que se evaluó la aparición de efectos adversos con relación al uso de este en el tratamiento de trastorno afectivo bipolar a nivel renal, endocrino-metabólico, gastrointestinal, neurológicos, dermatológicos y otros. Así mismo, se realizó un análisis de subgrupos en función de la polaridad de la enfermedad afectiva, el sexo, y la descontinuación como consecuencia de los efectos adversos del litio. Resultados. 14 estudios completaron los criterios de inclusión y de exclusión. Efectos adversos como la poliuria, temblor, molestias gastrointestinales y aumento de peso se relacionan con mayores niveles séricos de litio, pero la frecuencia de estos disminuye tras los primeros seis meses de tratamiento; y tienden a sobrerrepresentarse en pacientes con tendencia a la polaridad depresiva con relación a la eutimia o la polaridad maniaca. Con relación a la asociación entre los niveles séricos de litio y el desarrollo de enfermedad renal crónica, así como de hipotiroidismo, los resultados fueron concluyentes, y parece tener más importancia la edad de inicio del tratamiento y el tiempo de exposición al litio. Salvo por el hipotiroidismo y el aumento de peso, que son más frecuentes en mujeres, no parece haber diferencias significativas en la aparición de efectos adversos por sexo. No parece haber diferencias significativas en la tasa de descontinuación del tratamiento en relación con los niveles séricos de litio. Conclusión. En nuestra revisión no hay evidencia contundente que permita establecer que, al menos a dosis terapéuticas (niveles séricos de litio entre 0,4-1,2mmol/L) exista una asociación entre el aumento de los niveles séricos de litio y el aumento en la frecuencia de efectos adversos. Efectos adversos de autorreporte (poliuria, polidipsia, temblor, ganancia de peso, y quejas gastrointestinales) parecen tener asociación con mayores niveles séricos de litio; sin embargo, su frecuencia disminuye tras los primeros meses de tratamiento. Se requieren de estudios con manejo adecuado de los sesgos de selección y medición y con un adecuado control de variables de confusión, como la presencia de comorbilidades, la edad, la edad de inicio del tratamiento con litio, el tiempo de exposición, el uso de otros medicamentos, entre otros. Palabras clave: trastorno bipolar, litio, niveles séricos, tratamiento de mantenimiento, efectos adversos. (Texto tomado de la fuente)Serum lithium levels and occurrence of adverse effects during the maintenance phase in the treatment of bipolar affective disorder: a systematic review Introduction. Bipolar disorder (BD) is a chronic illness characterized by periods of relapse and remission that have a significant impact on morbidity, mortality, and public health. With the rise of psychopharmacology and the development of psychotropic drugs, relapse rates and the impact on patient morbidity and mortality have decreased. Although the therapeutic arsenal has expanded, lithium remains the treatment of choice in most clinical practice guidelines developed for the treatment of this disease. However, its prescription has been decreasing in part due to its safety profile. While the adverse effects and toxicity of lithium are well known, there is no precise evidence regarding the risk of these effects occurring depending on serum lithium levels, even at therapeutic doses. Objective. To evaluate the prognostic role of serum lithium levels in the occurrence of adverse effects in patients with bipolar affective disorder in the maintenance phase. Methods. A systematic review of literature was researched in multiple databases, including longitudinal observational and experimental studies that monitored participant’s serum lithium levels and evaluated the occurrence of adverse effects related to its use in the treatment of bipolar affective disorder in renal, endocrine-metabolic, gastrointestinal, neurological, dermatological, and other aspects. Subgroup analysis was also performed based on the polarity of affective illness, sex, and discontinuation due to lithium's adverse effects. Results. Fourteen studies met the inclusion and exclusion criteria. Adverse effects such as polyuria, tremor, gastrointestinal discomfort, and weight gain are related to higher serum levels of lithium, but the frequency of these effects decreases after the first six months of treatment; and they tend to be overrepresented in patients with a tendency to depressive polarity compared to euthymia or manic polarity. Regarding the association between serum lithium levels and the development of chronic kidney disease as well as hypothyroidism, the results were contradictory and insufficient for metabolic diseases, and the age at the start of treatment and the exposure time to lithium seem to be more important. Except for hypothyroidism and weight gain, which are more frequent in women, there do not seem to be significant differences in the occurrence of adverse effects by sex. There do not seem to be significant differences in the treatment discontinuation rate in relation to serum lithium levels. Conclusion. In our review there was no evidence to establish that, at least at therapeutic doses (serum lithium levels between 0.4-1.2mmol/L), there is an association between the increase in serum lithium levels and the increase in the frequency of adverse effects. Self-reported adverse effects (polyuria, polydipsia, tremor, weight gain, and gastrointestinal complaints) appear to be associated with higher serum lithium levels; however, their frequency decreases after the first months of treatment. Studies with proper management of selection and measurement biases are needed, as well as adequate control of confounding variables, such as the presence of comorbidities, age, age at the start of lithium treatment, exposure time, use of other medications, among others. Keywords: bipolar disorder, lithium, serum levels, maintenance treatment, adverse effects.Especialidades MédicasEspecialista en Psiquiatríaxi, 44 páginasapplication/pdfspaUniversidad Nacional de ColombiaBogotá - Medicina - Especialidad en PsiquiatríaFacultad de MedicinaBogotá, ColombiaUniversidad Nacional de Colombia - Sede Bogotá610 - Medicina y salud::615 - Farmacología y terapéutica610 - Medicina y salud::616 - EnfermedadesPsicofarmacologíaPsychopharmacologyTranstorno bipolarBipolar DisorderTrastorno bipolarLitioNiveles séricosTratamiento de mantenimientoEfectos adversosBipolar disorderLithiumSerum levelsMaintenance treatmentAdverse effectsNiveles séricos de litio y aparición de efectos adversos durante la fase de mantenimiento en el tratamiento de trastorno afectivo bipolar: una revisión sistemáticaSerum lithium levels and occurrence of adverse effects during the maintenance phase in the treatment of bipolar affective disorder: a systematic reviewTrabajo de grado - Especialidad Médicainfo:eu-repo/semantics/masterThesisinfo:eu-repo/semantics/acceptedVersionTexthttp://purl.org/redcol/resource_type/TMVieta, E., Berk, M., Schulze, T. et al. bipolar disorders. 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A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther. 1981 Aug;30(2):239-45.EstudiantesInvestigadoresPúblico generalResponsables políticosLICENSElicense.txtlicense.txttext/plain; charset=utf-85879https://repositorio.unal.edu.co/bitstream/unal/85502/3/license.txteb34b1cf90b7e1103fc9dfd26be24b4aMD53ORIGINAL1030636192.2024.pdf1030636192.2024.pdfTrabajo de Especialidad en Psiquiatríaapplication/pdf1064515https://repositorio.unal.edu.co/bitstream/unal/85502/4/1030636192.2024.pdf1131d547c120ae589fc8d7fbb42a3fa4MD54THUMBNAIL1030636192.2024.pdf.jpg1030636192.2024.pdf.jpgGenerated Thumbnailimage/jpeg4791https://repositorio.unal.edu.co/bitstream/unal/85502/5/1030636192.2024.pdf.jpgcb65070a8a356ec42ac6e7713c86fb00MD55unal/85502oai:repositorio.unal.edu.co:unal/855022024-01-29 23:03:53.03Repositorio Institucional Universidad Nacional de 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