Ng, Vanessa WS;
Leung, Miriam TY;
Lau, Wallis CY;
Chan, Esther W;
Hayes, Joseph F;
Osborn, David PJ;
Cheung, Ching-Lung;
... Man, Kenneth KC; + view all
(2024)
Lithium and the risk of fractures in patients with bipolar disorder: A population-based cohort study.
Psychiatry Research
, 339
, Article 116075. 10.1016/j.psychres.2024.116075.
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Abstract
Lithium is considered to be the most effective mood stabilizer for bipolar disorder. Evolving evidence suggested lithium can also regulate bone metabolism which may reduce the risk of fractures. While there are concerns about fractures for antipsychotics and mood stabilizing antiepileptics, very little is known about the overall risk of fractures associated with specific treatments. This study aimed to compare the risk of fractures in patients with bipolar disorder prescribed lithium, antipsychotics or mood stabilizing antiepileptics (valproate, lamotrigine, carbamazepine). Among 40,697 patients with bipolar disorder from 1993 to 2019 identified from a primary care electronic health record database in the UK, 13,385 were new users of mood stabilizing agents (lithium:2339; non-lithium: 11,046). Lithium was associated with a lower risk of fractures compared with non-lithium treatments (HR 0.66, 95 % CI 0.44–0.98). The results were similar when comparing lithium with prolactin raising and sparing antipsychotics, and individual antiepileptics. Lithium use may lower fracture risk, a benefit that is particularly relevant for patients with serious mental illness who are more prone to falls due to their behaviors. Our findings could help inform better treatment decisions for bipolar disorder, and lithium's potential to prevent fractures should be considered for patients at high risk of fractures.
| Type: | Article |
|---|---|
| Title: | Lithium and the risk of fractures in patients with bipolar disorder: A population-based cohort study |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.psychres.2024.116075 |
| Publisher version: | https://doi.org/10.1016/j.psychres.2024.116075 |
| Language: | English |
| Additional information: | Copyright © 2024 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
| Keywords: | Lithium, Antipsychotics, Antiepileptics, Fractures, Bones, Bipolar disorder, Electronic health records |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy > Practice and Policy |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10194064 |
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