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Lithium, a Therapy for AD: Current Evidence from Clinical Trials of Neurodegenerative Disorders

[ Vol. 13 , Issue. 8 ]

Author(s):

Orestes V. Forlenza, Ivan Aprahamian, Vanessa J. de Paula and Tomas Hajek   Pages 879 - 886 ( 8 )

Abstract:


Background: Preclinical studies have shown that lithium modifies pathological cascades implicated in certain neurodegenerative disorders, such as Alzheimer’s disease (AD), Huntigton`s disease (HD), multiple system atrophy (MSA) and amyotrophic lateral sclerosis (ALS). A critical question is whether these pharmacodynamic properties of lithium translate into neurodegenerative diseases modifying effects in human subjects. Methods: We reviewed all English controlled clinical trials published in PubMed, PsycINFO, Embase, SCOPUS, ISI-Web with the use of lithium for the treatment of neurodegenerative disorders between July 2004 and July 2014. Results: Lithium showed evidence for positive effects on cognitive functions and biomarkers in amnestic mild cognitive impairment (aMCI, 1 study) and AD (2 studies), even with doses lower than those used for mood stabilisation. Studies of Li in HD, MSA and CSI did not show benefits of lithium. However, due to methodological limitations and small sample size, these studies may be inconclusive. Studies in ALS showed consistently negative results and presented evidence against the use of lithium for the treatment of this disease. Conclusion: In absence of disease modifying treatments for any neurodegenerative disorders, the fact that at least 3 studies supported the effect of lithium in aMCI/AD is noteworthy. Future studies should focus on defining the dose range necessary for neuroprotective effects to occur.

Keywords:

Lithium and Alzheimer’s disease, lithium and mild cognitive impairment, lithium and amyotrophic lateral sclerosis, lithium and multiple system atrophy, lithium and neurodegenerative disorders, lithium.

Affiliation:

Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo. Rua Dr. Ovídio Pires de Campos 785, 05403-010 – São Paulo, SP, Brazil.



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