Lithium induced hypercalcemia: an expert opinion and management algorithm

Abstract Background Lithium is the gold standard prophylactic treatment for bipolar disorder. Most clinical practice guidelines recommend regular calcium assessments as part of monitoring lithium treatment, but easy-to-implement specific management strategies in the event of abnormal calcium levels...
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Autor*in:	Zoltan Kovacs [verfasserIn] Peter Vestergaard [verfasserIn] Rasmus W. Licht [verfasserIn] Sune P. V. Straszek [verfasserIn] Anne Sofie Hansen [verfasserIn] Allan H. Young [verfasserIn] Anne Duffy [verfasserIn] Bruno Müller-Oerlinghausen [verfasserIn] Florian Seemueller [verfasserIn] Gabriele Sani [verfasserIn] Janusz Rubakowski [verfasserIn] Josef Priller [verfasserIn] Lars Vedel Kessing [verfasserIn] Leonardo Tondo [verfasserIn] Martin Alda [verfasserIn] Mirko Manchia [verfasserIn] Paul Grof [verfasserIn] Phillip Ritter [verfasserIn] Tomas Hajek [verfasserIn] Ute Lewitzka [verfasserIn] Veerle Bergink [verfasserIn] Michael Bauer [verfasserIn] René Ernst Nielsen [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2022

Schlagwörter:	Lithium Side-effects Bipolar disorder Affective disorder

Übergeordnetes Werk:	In: International Journal of Bipolar Disorders - SpringerOpen, 2013, 10(2022), 1, Seite 7
Übergeordnetes Werk:	volume:10 ; year:2022 ; number:1 ; pages:7

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.1186/s40345-022-00283-3

Katalog-ID:	DOAJ020793006

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520			\|a Abstract Background Lithium is the gold standard prophylactic treatment for bipolar disorder. Most clinical practice guidelines recommend regular calcium assessments as part of monitoring lithium treatment, but easy-to-implement specific management strategies in the event of abnormal calcium levels are lacking. Methods Based on a narrative review of the effects of lithium on calcium and parathyroid hormone (PTH) homeostasis and its clinical implications, experts developed a step-by-step algorithm to guide the initial management of emergent hypercalcemia during lithium treatment. Results In the event of albumin-corrected plasma calcium levels above the upper limit, PTH and calcium levels should be measured after two weeks. Measurement of PTH and calcium levels should preferably be repeated after one month in case of normal or high PTH level, and after one week in case of low PTH level, independently of calcium levels. Calcium levels above 2.8 mmol/l may require a more acute approach. If PTH and calcium levels are normalized, repeated measurements are suggested after six months. In case of persistent PTH and calcium abnormalities, referral to an endocrinologist is suggested since further examination may be needed. Conclusions Standardized consensus driven management may diminish the potential risk of clinicians avoiding the use of lithium because of uncertainties about managing side-effects and consequently hindering some patients from receiving an optimal treatment.
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650		4	\|a Bipolar disorder
650		4	\|a Affective disorder
653		0	\|a Neurosciences. Biological psychiatry. Neuropsychiatry
653		0	\|a Neurophysiology and neuropsychology
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700	0		\|a Sune P. V. Straszek \|e verfasserin \|4 aut
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700	0		\|a Veerle Bergink \|e verfasserin \|4 aut
700	0		\|a Michael Bauer \|e verfasserin \|4 aut
700	0		\|a René Ernst Nielsen \|e verfasserin \|4 aut
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allfields	10.1186/s40345-022-00283-3 doi (DE-627)DOAJ020793006 (DE-599)DOAJ0b61b469fe494211958f513da460d848 DE-627 ger DE-627 rakwb eng RC321-571 QP351-495 Zoltan Kovacs verfasserin aut Lithium induced hypercalcemia: an expert opinion and management algorithm 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Lithium is the gold standard prophylactic treatment for bipolar disorder. Most clinical practice guidelines recommend regular calcium assessments as part of monitoring lithium treatment, but easy-to-implement specific management strategies in the event of abnormal calcium levels are lacking. Methods Based on a narrative review of the effects of lithium on calcium and parathyroid hormone (PTH) homeostasis and its clinical implications, experts developed a step-by-step algorithm to guide the initial management of emergent hypercalcemia during lithium treatment. Results In the event of albumin-corrected plasma calcium levels above the upper limit, PTH and calcium levels should be measured after two weeks. Measurement of PTH and calcium levels should preferably be repeated after one month in case of normal or high PTH level, and after one week in case of low PTH level, independently of calcium levels. Calcium levels above 2.8 mmol/l may require a more acute approach. If PTH and calcium levels are normalized, repeated measurements are suggested after six months. In case of persistent PTH and calcium abnormalities, referral to an endocrinologist is suggested since further examination may be needed. Conclusions Standardized consensus driven management may diminish the potential risk of clinicians avoiding the use of lithium because of uncertainties about managing side-effects and consequently hindering some patients from receiving an optimal treatment. Lithium Side-effects Bipolar disorder Affective disorder Neurosciences. Biological psychiatry. Neuropsychiatry Neurophysiology and neuropsychology Peter Vestergaard verfasserin aut Rasmus W. Licht verfasserin aut Sune P. V. Straszek verfasserin aut Anne Sofie Hansen verfasserin aut Allan H. Young verfasserin aut Anne Duffy verfasserin aut Bruno Müller-Oerlinghausen verfasserin aut Florian Seemueller verfasserin aut Gabriele Sani verfasserin aut Janusz Rubakowski verfasserin aut Josef Priller verfasserin aut Lars Vedel Kessing verfasserin aut Leonardo Tondo verfasserin aut Martin Alda verfasserin aut Mirko Manchia verfasserin aut Paul Grof verfasserin aut Phillip Ritter verfasserin aut Tomas Hajek verfasserin aut Ute Lewitzka verfasserin aut Veerle Bergink verfasserin aut Michael Bauer verfasserin aut René Ernst Nielsen verfasserin aut In International Journal of Bipolar Disorders SpringerOpen, 2013 10(2022), 1, Seite 7 (DE-627)768094763 (DE-600)2732954-9 21947511 nnns volume:10 year:2022 number:1 pages:7 https://doi.org/10.1186/s40345-022-00283-3 kostenfrei https://doaj.org/article/0b61b469fe494211958f513da460d848 kostenfrei https://doi.org/10.1186/s40345-022-00283-3 kostenfrei https://doaj.org/toc/2194-7511 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2022 1 7
spelling	10.1186/s40345-022-00283-3 doi (DE-627)DOAJ020793006 (DE-599)DOAJ0b61b469fe494211958f513da460d848 DE-627 ger DE-627 rakwb eng RC321-571 QP351-495 Zoltan Kovacs verfasserin aut Lithium induced hypercalcemia: an expert opinion and management algorithm 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Lithium is the gold standard prophylactic treatment for bipolar disorder. Most clinical practice guidelines recommend regular calcium assessments as part of monitoring lithium treatment, but easy-to-implement specific management strategies in the event of abnormal calcium levels are lacking. Methods Based on a narrative review of the effects of lithium on calcium and parathyroid hormone (PTH) homeostasis and its clinical implications, experts developed a step-by-step algorithm to guide the initial management of emergent hypercalcemia during lithium treatment. Results In the event of albumin-corrected plasma calcium levels above the upper limit, PTH and calcium levels should be measured after two weeks. Measurement of PTH and calcium levels should preferably be repeated after one month in case of normal or high PTH level, and after one week in case of low PTH level, independently of calcium levels. Calcium levels above 2.8 mmol/l may require a more acute approach. If PTH and calcium levels are normalized, repeated measurements are suggested after six months. In case of persistent PTH and calcium abnormalities, referral to an endocrinologist is suggested since further examination may be needed. Conclusions Standardized consensus driven management may diminish the potential risk of clinicians avoiding the use of lithium because of uncertainties about managing side-effects and consequently hindering some patients from receiving an optimal treatment. Lithium Side-effects Bipolar disorder Affective disorder Neurosciences. Biological psychiatry. Neuropsychiatry Neurophysiology and neuropsychology Peter Vestergaard verfasserin aut Rasmus W. Licht verfasserin aut Sune P. V. Straszek verfasserin aut Anne Sofie Hansen verfasserin aut Allan H. Young verfasserin aut Anne Duffy verfasserin aut Bruno Müller-Oerlinghausen verfasserin aut Florian Seemueller verfasserin aut Gabriele Sani verfasserin aut Janusz Rubakowski verfasserin aut Josef Priller verfasserin aut Lars Vedel Kessing verfasserin aut Leonardo Tondo verfasserin aut Martin Alda verfasserin aut Mirko Manchia verfasserin aut Paul Grof verfasserin aut Phillip Ritter verfasserin aut Tomas Hajek verfasserin aut Ute Lewitzka verfasserin aut Veerle Bergink verfasserin aut Michael Bauer verfasserin aut René Ernst Nielsen verfasserin aut In International Journal of Bipolar Disorders SpringerOpen, 2013 10(2022), 1, Seite 7 (DE-627)768094763 (DE-600)2732954-9 21947511 nnns volume:10 year:2022 number:1 pages:7 https://doi.org/10.1186/s40345-022-00283-3 kostenfrei https://doaj.org/article/0b61b469fe494211958f513da460d848 kostenfrei https://doi.org/10.1186/s40345-022-00283-3 kostenfrei https://doaj.org/toc/2194-7511 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2022 1 7
allfields_unstemmed	10.1186/s40345-022-00283-3 doi (DE-627)DOAJ020793006 (DE-599)DOAJ0b61b469fe494211958f513da460d848 DE-627 ger DE-627 rakwb eng RC321-571 QP351-495 Zoltan Kovacs verfasserin aut Lithium induced hypercalcemia: an expert opinion and management algorithm 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Lithium is the gold standard prophylactic treatment for bipolar disorder. Most clinical practice guidelines recommend regular calcium assessments as part of monitoring lithium treatment, but easy-to-implement specific management strategies in the event of abnormal calcium levels are lacking. Methods Based on a narrative review of the effects of lithium on calcium and parathyroid hormone (PTH) homeostasis and its clinical implications, experts developed a step-by-step algorithm to guide the initial management of emergent hypercalcemia during lithium treatment. Results In the event of albumin-corrected plasma calcium levels above the upper limit, PTH and calcium levels should be measured after two weeks. Measurement of PTH and calcium levels should preferably be repeated after one month in case of normal or high PTH level, and after one week in case of low PTH level, independently of calcium levels. Calcium levels above 2.8 mmol/l may require a more acute approach. If PTH and calcium levels are normalized, repeated measurements are suggested after six months. In case of persistent PTH and calcium abnormalities, referral to an endocrinologist is suggested since further examination may be needed. Conclusions Standardized consensus driven management may diminish the potential risk of clinicians avoiding the use of lithium because of uncertainties about managing side-effects and consequently hindering some patients from receiving an optimal treatment. Lithium Side-effects Bipolar disorder Affective disorder Neurosciences. Biological psychiatry. Neuropsychiatry Neurophysiology and neuropsychology Peter Vestergaard verfasserin aut Rasmus W. Licht verfasserin aut Sune P. V. Straszek verfasserin aut Anne Sofie Hansen verfasserin aut Allan H. Young verfasserin aut Anne Duffy verfasserin aut Bruno Müller-Oerlinghausen verfasserin aut Florian Seemueller verfasserin aut Gabriele Sani verfasserin aut Janusz Rubakowski verfasserin aut Josef Priller verfasserin aut Lars Vedel Kessing verfasserin aut Leonardo Tondo verfasserin aut Martin Alda verfasserin aut Mirko Manchia verfasserin aut Paul Grof verfasserin aut Phillip Ritter verfasserin aut Tomas Hajek verfasserin aut Ute Lewitzka verfasserin aut Veerle Bergink verfasserin aut Michael Bauer verfasserin aut René Ernst Nielsen verfasserin aut In International Journal of Bipolar Disorders SpringerOpen, 2013 10(2022), 1, Seite 7 (DE-627)768094763 (DE-600)2732954-9 21947511 nnns volume:10 year:2022 number:1 pages:7 https://doi.org/10.1186/s40345-022-00283-3 kostenfrei https://doaj.org/article/0b61b469fe494211958f513da460d848 kostenfrei https://doi.org/10.1186/s40345-022-00283-3 kostenfrei https://doaj.org/toc/2194-7511 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2022 1 7
allfieldsGer	10.1186/s40345-022-00283-3 doi (DE-627)DOAJ020793006 (DE-599)DOAJ0b61b469fe494211958f513da460d848 DE-627 ger DE-627 rakwb eng RC321-571 QP351-495 Zoltan Kovacs verfasserin aut Lithium induced hypercalcemia: an expert opinion and management algorithm 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Lithium is the gold standard prophylactic treatment for bipolar disorder. Most clinical practice guidelines recommend regular calcium assessments as part of monitoring lithium treatment, but easy-to-implement specific management strategies in the event of abnormal calcium levels are lacking. Methods Based on a narrative review of the effects of lithium on calcium and parathyroid hormone (PTH) homeostasis and its clinical implications, experts developed a step-by-step algorithm to guide the initial management of emergent hypercalcemia during lithium treatment. Results In the event of albumin-corrected plasma calcium levels above the upper limit, PTH and calcium levels should be measured after two weeks. Measurement of PTH and calcium levels should preferably be repeated after one month in case of normal or high PTH level, and after one week in case of low PTH level, independently of calcium levels. Calcium levels above 2.8 mmol/l may require a more acute approach. If PTH and calcium levels are normalized, repeated measurements are suggested after six months. In case of persistent PTH and calcium abnormalities, referral to an endocrinologist is suggested since further examination may be needed. Conclusions Standardized consensus driven management may diminish the potential risk of clinicians avoiding the use of lithium because of uncertainties about managing side-effects and consequently hindering some patients from receiving an optimal treatment. Lithium Side-effects Bipolar disorder Affective disorder Neurosciences. Biological psychiatry. Neuropsychiatry Neurophysiology and neuropsychology Peter Vestergaard verfasserin aut Rasmus W. Licht verfasserin aut Sune P. V. Straszek verfasserin aut Anne Sofie Hansen verfasserin aut Allan H. Young verfasserin aut Anne Duffy verfasserin aut Bruno Müller-Oerlinghausen verfasserin aut Florian Seemueller verfasserin aut Gabriele Sani verfasserin aut Janusz Rubakowski verfasserin aut Josef Priller verfasserin aut Lars Vedel Kessing verfasserin aut Leonardo Tondo verfasserin aut Martin Alda verfasserin aut Mirko Manchia verfasserin aut Paul Grof verfasserin aut Phillip Ritter verfasserin aut Tomas Hajek verfasserin aut Ute Lewitzka verfasserin aut Veerle Bergink verfasserin aut Michael Bauer verfasserin aut René Ernst Nielsen verfasserin aut In International Journal of Bipolar Disorders SpringerOpen, 2013 10(2022), 1, Seite 7 (DE-627)768094763 (DE-600)2732954-9 21947511 nnns volume:10 year:2022 number:1 pages:7 https://doi.org/10.1186/s40345-022-00283-3 kostenfrei https://doaj.org/article/0b61b469fe494211958f513da460d848 kostenfrei https://doi.org/10.1186/s40345-022-00283-3 kostenfrei https://doaj.org/toc/2194-7511 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2022 1 7
allfieldsSound	10.1186/s40345-022-00283-3 doi (DE-627)DOAJ020793006 (DE-599)DOAJ0b61b469fe494211958f513da460d848 DE-627 ger DE-627 rakwb eng RC321-571 QP351-495 Zoltan Kovacs verfasserin aut Lithium induced hypercalcemia: an expert opinion and management algorithm 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Lithium is the gold standard prophylactic treatment for bipolar disorder. Most clinical practice guidelines recommend regular calcium assessments as part of monitoring lithium treatment, but easy-to-implement specific management strategies in the event of abnormal calcium levels are lacking. Methods Based on a narrative review of the effects of lithium on calcium and parathyroid hormone (PTH) homeostasis and its clinical implications, experts developed a step-by-step algorithm to guide the initial management of emergent hypercalcemia during lithium treatment. Results In the event of albumin-corrected plasma calcium levels above the upper limit, PTH and calcium levels should be measured after two weeks. Measurement of PTH and calcium levels should preferably be repeated after one month in case of normal or high PTH level, and after one week in case of low PTH level, independently of calcium levels. Calcium levels above 2.8 mmol/l may require a more acute approach. If PTH and calcium levels are normalized, repeated measurements are suggested after six months. In case of persistent PTH and calcium abnormalities, referral to an endocrinologist is suggested since further examination may be needed. Conclusions Standardized consensus driven management may diminish the potential risk of clinicians avoiding the use of lithium because of uncertainties about managing side-effects and consequently hindering some patients from receiving an optimal treatment. Lithium Side-effects Bipolar disorder Affective disorder Neurosciences. Biological psychiatry. Neuropsychiatry Neurophysiology and neuropsychology Peter Vestergaard verfasserin aut Rasmus W. Licht verfasserin aut Sune P. V. Straszek verfasserin aut Anne Sofie Hansen verfasserin aut Allan H. Young verfasserin aut Anne Duffy verfasserin aut Bruno Müller-Oerlinghausen verfasserin aut Florian Seemueller verfasserin aut Gabriele Sani verfasserin aut Janusz Rubakowski verfasserin aut Josef Priller verfasserin aut Lars Vedel Kessing verfasserin aut Leonardo Tondo verfasserin aut Martin Alda verfasserin aut Mirko Manchia verfasserin aut Paul Grof verfasserin aut Phillip Ritter verfasserin aut Tomas Hajek verfasserin aut Ute Lewitzka verfasserin aut Veerle Bergink verfasserin aut Michael Bauer verfasserin aut René Ernst Nielsen verfasserin aut In International Journal of Bipolar Disorders SpringerOpen, 2013 10(2022), 1, Seite 7 (DE-627)768094763 (DE-600)2732954-9 21947511 nnns volume:10 year:2022 number:1 pages:7 https://doi.org/10.1186/s40345-022-00283-3 kostenfrei https://doaj.org/article/0b61b469fe494211958f513da460d848 kostenfrei https://doi.org/10.1186/s40345-022-00283-3 kostenfrei https://doaj.org/toc/2194-7511 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2022 1 7
language	English
source	In International Journal of Bipolar Disorders 10(2022), 1, Seite 7 volume:10 year:2022 number:1 pages:7
sourceStr	In International Journal of Bipolar Disorders 10(2022), 1, Seite 7 volume:10 year:2022 number:1 pages:7
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Lithium Side-effects Bipolar disorder Affective disorder Neurosciences. Biological psychiatry. Neuropsychiatry Neurophysiology and neuropsychology
isfreeaccess_bool	true
container_title	International Journal of Bipolar Disorders
authorswithroles_txt_mv	Zoltan Kovacs @@aut@@ Peter Vestergaard @@aut@@ Rasmus W. Licht @@aut@@ Sune P. V. Straszek @@aut@@ Anne Sofie Hansen @@aut@@ Allan H. Young @@aut@@ Anne Duffy @@aut@@ Bruno Müller-Oerlinghausen @@aut@@ Florian Seemueller @@aut@@ Gabriele Sani @@aut@@ Janusz Rubakowski @@aut@@ Josef Priller @@aut@@ Lars Vedel Kessing @@aut@@ Leonardo Tondo @@aut@@ Martin Alda @@aut@@ Mirko Manchia @@aut@@ Paul Grof @@aut@@ Phillip Ritter @@aut@@ Tomas Hajek @@aut@@ Ute Lewitzka @@aut@@ Veerle Bergink @@aut@@ Michael Bauer @@aut@@ René Ernst Nielsen @@aut@@
publishDateDaySort_date	2022-01-01T00:00:00Z
hierarchy_top_id	768094763
id	DOAJ020793006
language_de	englisch
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callnumber-first	R - Medicine
author	Zoltan Kovacs
spellingShingle	Zoltan Kovacs misc RC321-571 misc QP351-495 misc Lithium misc Side-effects misc Bipolar disorder misc Affective disorder misc Neurosciences. Biological psychiatry. Neuropsychiatry misc Neurophysiology and neuropsychology Lithium induced hypercalcemia: an expert opinion and management algorithm
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topic_title	RC321-571 QP351-495 Lithium induced hypercalcemia: an expert opinion and management algorithm Lithium Side-effects Bipolar disorder Affective disorder
topic	misc RC321-571 misc QP351-495 misc Lithium misc Side-effects misc Bipolar disorder misc Affective disorder misc Neurosciences. Biological psychiatry. Neuropsychiatry misc Neurophysiology and neuropsychology
topic_unstemmed	misc RC321-571 misc QP351-495 misc Lithium misc Side-effects misc Bipolar disorder misc Affective disorder misc Neurosciences. Biological psychiatry. Neuropsychiatry misc Neurophysiology and neuropsychology
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title	Lithium induced hypercalcemia: an expert opinion and management algorithm
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title_full	Lithium induced hypercalcemia: an expert opinion and management algorithm
author_sort	Zoltan Kovacs
journal	International Journal of Bipolar Disorders
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author_browse	Zoltan Kovacs Peter Vestergaard Rasmus W. Licht Sune P. V. Straszek Anne Sofie Hansen Allan H. Young Anne Duffy Bruno Müller-Oerlinghausen Florian Seemueller Gabriele Sani Janusz Rubakowski Josef Priller Lars Vedel Kessing Leonardo Tondo Martin Alda Mirko Manchia Paul Grof Phillip Ritter Tomas Hajek Ute Lewitzka Veerle Bergink Michael Bauer René Ernst Nielsen
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author2-role	verfasserin
title_sort	lithium induced hypercalcemia: an expert opinion and management algorithm
callnumber	RC321-571
title_auth	Lithium induced hypercalcemia: an expert opinion and management algorithm
abstract	Abstract Background Lithium is the gold standard prophylactic treatment for bipolar disorder. Most clinical practice guidelines recommend regular calcium assessments as part of monitoring lithium treatment, but easy-to-implement specific management strategies in the event of abnormal calcium levels are lacking. Methods Based on a narrative review of the effects of lithium on calcium and parathyroid hormone (PTH) homeostasis and its clinical implications, experts developed a step-by-step algorithm to guide the initial management of emergent hypercalcemia during lithium treatment. Results In the event of albumin-corrected plasma calcium levels above the upper limit, PTH and calcium levels should be measured after two weeks. Measurement of PTH and calcium levels should preferably be repeated after one month in case of normal or high PTH level, and after one week in case of low PTH level, independently of calcium levels. Calcium levels above 2.8 mmol/l may require a more acute approach. If PTH and calcium levels are normalized, repeated measurements are suggested after six months. In case of persistent PTH and calcium abnormalities, referral to an endocrinologist is suggested since further examination may be needed. Conclusions Standardized consensus driven management may diminish the potential risk of clinicians avoiding the use of lithium because of uncertainties about managing side-effects and consequently hindering some patients from receiving an optimal treatment.
abstractGer	Abstract Background Lithium is the gold standard prophylactic treatment for bipolar disorder. Most clinical practice guidelines recommend regular calcium assessments as part of monitoring lithium treatment, but easy-to-implement specific management strategies in the event of abnormal calcium levels are lacking. Methods Based on a narrative review of the effects of lithium on calcium and parathyroid hormone (PTH) homeostasis and its clinical implications, experts developed a step-by-step algorithm to guide the initial management of emergent hypercalcemia during lithium treatment. Results In the event of albumin-corrected plasma calcium levels above the upper limit, PTH and calcium levels should be measured after two weeks. Measurement of PTH and calcium levels should preferably be repeated after one month in case of normal or high PTH level, and after one week in case of low PTH level, independently of calcium levels. Calcium levels above 2.8 mmol/l may require a more acute approach. If PTH and calcium levels are normalized, repeated measurements are suggested after six months. In case of persistent PTH and calcium abnormalities, referral to an endocrinologist is suggested since further examination may be needed. Conclusions Standardized consensus driven management may diminish the potential risk of clinicians avoiding the use of lithium because of uncertainties about managing side-effects and consequently hindering some patients from receiving an optimal treatment.
abstract_unstemmed	Abstract Background Lithium is the gold standard prophylactic treatment for bipolar disorder. Most clinical practice guidelines recommend regular calcium assessments as part of monitoring lithium treatment, but easy-to-implement specific management strategies in the event of abnormal calcium levels are lacking. Methods Based on a narrative review of the effects of lithium on calcium and parathyroid hormone (PTH) homeostasis and its clinical implications, experts developed a step-by-step algorithm to guide the initial management of emergent hypercalcemia during lithium treatment. Results In the event of albumin-corrected plasma calcium levels above the upper limit, PTH and calcium levels should be measured after two weeks. Measurement of PTH and calcium levels should preferably be repeated after one month in case of normal or high PTH level, and after one week in case of low PTH level, independently of calcium levels. Calcium levels above 2.8 mmol/l may require a more acute approach. If PTH and calcium levels are normalized, repeated measurements are suggested after six months. In case of persistent PTH and calcium abnormalities, referral to an endocrinologist is suggested since further examination may be needed. Conclusions Standardized consensus driven management may diminish the potential risk of clinicians avoiding the use of lithium because of uncertainties about managing side-effects and consequently hindering some patients from receiving an optimal treatment.
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title_short	Lithium induced hypercalcemia: an expert opinion and management algorithm
url	https://doi.org/10.1186/s40345-022-00283-3 https://doaj.org/article/0b61b469fe494211958f513da460d848 https://doaj.org/toc/2194-7511
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author2	Peter Vestergaard Rasmus W. Licht Sune P. V. Straszek Anne Sofie Hansen Allan H. Young Anne Duffy Bruno Müller-Oerlinghausen Florian Seemueller Gabriele Sani Janusz Rubakowski Josef Priller Lars Vedel Kessing Leonardo Tondo Martin Alda Mirko Manchia Paul Grof Phillip Ritter Tomas Hajek Ute Lewitzka Veerle Bergink Michael Bauer René Ernst Nielsen
author2Str	Peter Vestergaard Rasmus W. Licht Sune P. V. Straszek Anne Sofie Hansen Allan H. Young Anne Duffy Bruno Müller-Oerlinghausen Florian Seemueller Gabriele Sani Janusz Rubakowski Josef Priller Lars Vedel Kessing Leonardo Tondo Martin Alda Mirko Manchia Paul Grof Phillip Ritter Tomas Hajek Ute Lewitzka Veerle Bergink Michael Bauer René Ernst Nielsen
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