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  1. Article: Respiratory infections during lithium and valproate medication: a within-individual prospective study of 50,000 patients with bipolar disorder.

    Landén, Mikael / Larsson, Henrik / Lichtenstein, Paul / Westin, Johan / Song, Jie

    International journal of bipolar disorders

    2021  Volume 9, Issue 1, Page(s) 4

    Abstract: ... from human studies is scarce. Lithium is used as a mood stabilizer to treat patients with bipolar disorder ... of respiratory infections in patients with bipolar disorder. To rule out the possibility that a potential association ... respiratory infections were documented in the Swedish Patient Register. The incidence rate was 28% lower during lithium ...

    Abstract Background: In vitro studies have demonstrated that lithium has antiviral properties, but evidence from human studies is scarce. Lithium is used as a mood stabilizer to treat patients with bipolar disorder. Here, the aim was to investigate the association between lithium use and the risk of respiratory infections in patients with bipolar disorder. To rule out the possibility that a potential association could be due to lithium's effect on psychiatric symptoms, we also studied the effect of valproate, which is an alternative to lithium used to prevent mood episodes in bipolar disorder.
    Method: We followed 51,509 individuals diagnosed with bipolar disorder in the Swedish Patient register 2005-2013. We applied a within-individual design using stratified Cox regression to estimate the hazard ratios (HRs) of respiratory infections during treated periods compared with untreated periods.
    Results: During follow-up, 5,760 respiratory infections were documented in the Swedish Patient Register. The incidence rate was 28% lower during lithium treatment (HR 0.73, 95% CI 0.61-0.86) and 35% higher during valproate treatment (HR 1.35, 95% CI 1.06-1.73) compared with periods off treatment.
    Conclusions: This study provides real-world evidence that lithium is associated with decreased risk for respiratory infections and suggests that the repurposing potential of lithium for potential antiviral or antibacterial effects is worthy of investigation.
    Language English
    Publishing date 2021-02-01
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2732954-9
    ISSN 2194-7511
    ISSN 2194-7511
    DOI 10.1186/s40345-020-00208-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Respiratory infection during lithium and valproate medication: a within-individual prospective study of 50,000 patients with bipolar disorder

    Landen, M. / Lichtenstein, P. / Larsson, H. / Song, J.

    Abstract: ... from human studies is scarce. Lithium is used as a mood stabilizer to treat patients with bipolar disorder ... alternative to lithium to prevent mood episodes in bipolar disorder, valproate. Method: We followed 51,509 ... of respiratory infections in patients with bipolar disorder. To rule out the possibility that a potential association ...

    Abstract Objective: In vitro studies have demonstrated that lithium has antiviral properties, but evidence from human studies is scarce. Lithium is used as a mood stabilizer to treat patients with bipolar disorder. Here, the aim was to investigate the association between lithium use and the risk of respiratory infections in patients with bipolar disorder. To rule out the possibility that a potential association could be due to lithium's effect on psychiatric symptoms, we also studied the effect of the most common alternative to lithium to prevent mood episodes in bipolar disorder, valproate. Method: We followed 51,509 individuals diagnosed with bipolar disorder in the Swedish Patient register 2005-2013. We applied a with-individual design using stratified Cox regression to estimate the hazard ratios (HRs) of respiratory infections during treated periods compared with untreated periods. Results: During follow-up, 5,760 respiratory infections were documented in the Swedish Patient Register. The incidence rate was 28% lower during lithium treatment (HR 0.73, 95% CI 0.61-0.86) and 35% higher during valproate treatment (HR 1.35, 95% CI 1.06-1.73) compared with periods off treatment. Conclusions: This study provides real-world evidence that lithium protects against respiratory infections and suggests that the repurposing potential of lithium for antiviral effects is worthy of investigation.
    Keywords covid19
    Publisher MedRxiv
    Document type Article ; Online
    DOI 10.1101/2020.05.04.20090084
    Database COVID19

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