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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Phillipa on April 12, 2010, at 20:24:13
I didn't know that some thought lithium dulls cognition maybe why some go off meds. Phillipa
Bipolar Illness, Not Lithium, Impairs Cognitive Function
NEW YORK (Reuters Health) Apr 08 - Lithium may not have harmful neuropsychological effects on patients with bipolar illness, new research suggests. Instead, the disease itself appears to be responsible for the cognitive deficits seen in these patients.In fact, the researchers say, lithium "looks quite safe," and cognitive impairment "seems to be independent of medication" in these individuals.
The finding that bipolar patients in remission have cognitive deficits not related to medication is an important one, "because the vast majority of studies claiming to find such deficits have been conducted on patients taking medication or acutely ill," say lead author Dr. Carlos Lopez-Jaramillo and his colleagues.
Dr. Lopez-Jaramillo of the Universidad de Antioquia in Medellin, Colombia, and associates administered a series of cognitive function tests to three groups: 20 patients with bipolar disorder who had been euthymic for at least six months and were not taking medication; 20 patients with bipolar illness, also in remission, who had been on lithium monotherapy at therapeutic blood levels (0.6-1.2 mEq/L) for at least two months; and 20 healthy controls with no history of mental illness.
Compared to the controls, the medicated patients scored worse in the cued recall and cued delayed recall variables of the test for associative memory with semantic increase; the recognition of logical memory of the Wechsler Memory Scale; and the free short recall, cued short recall, and cued delayed recall variables of the California Verbal Learning Test (CVLT).
But when the researchers compared the unmedicated bipolar patients to the healthy controls, these patients showed the same deficits as the medicated patients. In addition, they also scored worse than controls on the Wechsler Scale's backward digits and recognition of logical memory variables.
There were no significant differences between the medicated and unmedicated groups on neuropsychological variables, according to the report, which appeared online March 23rd in the Journal of Clinical Psychiatry.
While the study is small, the researchers note that it is difficult to find truly euthymic bipolar patients who are either unmedicated or only taking lithium, "because polypharmacy is a clinical reality in bipolar disorder." Gathering the current sample, they add, took several years.
Dr. Lopez-Jaramillo and his colleagues suggest that bipolar patients may perform worse on tests of verbal and visual-verbal episodic memory because they have more difficulty using "semantic associations that favor their information storing and recall processes."
"It has been reported that some patients might stop...treatment as a consequence of their concern for the negative effects that lithium could bear on cognition, substantially increasing their risk of relapse as a consequence," the authors note.
But despite concerns that lithium could slow processing and psychomotor performance, the current study found no difference in these abilities between the medicated and unmedicated bipolar patients, they add.
The patients' verbal memory deficits "are not explained by medication or by lithium monotherapy, but by the condition itself," the investigators conclude.
J Clin Psychiatry 2010.
Posted by herpills on April 13, 2010, at 11:19:01
In reply to Bipolar illness not lithium effects cognition, posted by Phillipa on April 12, 2010, at 20:24:13
Interesting. I would like to see a similar study done with the anticonvulsants...
herpills
Posted by SLS on April 13, 2010, at 16:43:27
In reply to Re: Bipolar illness not lithium effects cognition » Phillipa, posted by herpills on April 13, 2010, at 11:19:01
> Interesting. I would like to see a similar study done with the anticonvulsants...
Yes. I can testify that lamotrigine can produce impairments in cognition and memory. Lithium does not affect me that way.
- Scott
Posted by Phillipa on April 13, 2010, at 20:30:41
In reply to Re: Bipolar illness not lithium effects cognition, posted by SLS on April 13, 2010, at 16:43:27
I don't understand the neuroprotection of lithium? Most I knew on it had weight gain, tremors, diarrhea? Phillipa
Posted by 49er on April 14, 2010, at 7:16:27
In reply to Bipolar illness not lithium effects cognition, posted by Phillipa on April 12, 2010, at 20:24:13
> I didn't know that some thought lithium dulls cognition maybe why some go off meds. Phillipa
>
> Bipolar Illness, Not Lithium, Impairs Cognitive Function
>
>
>
> NEW YORK (Reuters Health) Apr 08 - Lithium may not have harmful neuropsychological effects on patients with bipolar illness, new research suggests. Instead, the disease itself appears to be responsible for the cognitive deficits seen in these patients.
>
> In fact, the researchers say, lithium "looks quite safe," and cognitive impairment "seems to be independent of medication" in these individuals.
>
> The finding that bipolar patients in remission have cognitive deficits not related to medication is an important one, "because the vast majority of studies claiming to find such deficits have been conducted on patients taking medication or acutely ill," say lead author Dr. Carlos Lopez-Jaramillo and his colleagues.
>
> Dr. Lopez-Jaramillo of the Universidad de Antioquia in Medellin, Colombia, and associates administered a series of cognitive function tests to three groups: 20 patients with bipolar disorder who had been euthymic for at least six months and were not taking medication; 20 patients with bipolar illness, also in remission, who had been on lithium monotherapy at therapeutic blood levels (0.6-1.2 mEq/L) for at least two months; and 20 healthy controls with no history of mental illness.
>
> Compared to the controls, the medicated patients scored worse in the cued recall and cued delayed recall variables of the test for associative memory with semantic increase; the recognition of logical memory of the Wechsler Memory Scale; and the free short recall, cued short recall, and cued delayed recall variables of the California Verbal Learning Test (CVLT).
>
> But when the researchers compared the unmedicated bipolar patients to the healthy controls, these patients showed the same deficits as the medicated patients. In addition, they also scored worse than controls on the Wechsler Scale's backward digits and recognition of logical memory variables.
>
> There were no significant differences between the medicated and unmedicated groups on neuropsychological variables, according to the report, which appeared online March 23rd in the Journal of Clinical Psychiatry.
>
> While the study is small, the researchers note that it is difficult to find truly euthymic bipolar patients who are either unmedicated or only taking lithium, "because polypharmacy is a clinical reality in bipolar disorder." Gathering the current sample, they add, took several years.
>
> Dr. Lopez-Jaramillo and his colleagues suggest that bipolar patients may perform worse on tests of verbal and visual-verbal episodic memory because they have more difficulty using "semantic associations that favor their information storing and recall processes."
>
> "It has been reported that some patients might stop...treatment as a consequence of their concern for the negative effects that lithium could bear on cognition, substantially increasing their risk of relapse as a consequence," the authors note.
>
> But despite concerns that lithium could slow processing and psychomotor performance, the current study found no difference in these abilities between the medicated and unmedicated bipolar patients, they add.
>
> The patients' verbal memory deficits "are not explained by medication or by lithium monotherapy, but by the condition itself," the investigators conclude.
>
> J Clin Psychiatry 2010.
>Hi Philipa,
What I would like to know is where the unmedicated patients on drugs prior to being unmedicated for 6 months because quick med taperings can definitely effect cognition.
Also. I would have liked to have known what the scores were on the neuropsych tests. One person's version of statistically significant or not important might be different from another professional's.
Additionally, as someone wonderfully pointed out in the thread on Zoloft and Cancer, researchers miss the long term effects of these meds. When I started on psych meds, I feel they improved my cognition. But long term, they worsened it and I know it was't related to depression as I definitely know the difference.
Anyway, studies like this are very frustrating as they are portrayed as facts when so much information is missing and the media doesn't apply critical analysis.
49er
Posted by Phillipa on April 14, 2010, at 19:57:16
In reply to Re: Bipolar illness not lithium effects cognition » Phillipa, posted by 49er on April 14, 2010, at 7:16:27
HI 49er it's an example of what the professionals that treat are being told per nursing newsletter. I do agree with you also. Phillipa
This is the end of the thread.
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