EVALUTION OF PATIENTS ON CHRONIC LITHIUM TREATMENT: A CROSS SECTIONEAL STUDY

Abstract

Lithium remains an essential component of long-term treatment maintenance of the bipolar disorder; however, it is associated with possible endocrine, renal and cardiac adverse events that require close monitoring. The current study aimed to examine the effects of the chronic lithium use on thyroid, glomerular filtration rate, lithium serum levels, and electrocardiographic changes. It was a cross-sectional study that tested 130 long-term lithium patients. The biochemical variables such as serum lithium, creatinine, triiodothyronine (T3), thyroxine (T4) as well as thyroid-stimulating hormone (TSH) were measured. As an assessment of renal functioning, the estimated glomerular filtration rate (eGFR) was evaluated, and electrocardiographic defects were documented. The correlation studies were carried out to reveal the relationships between lithium dose, length of therapy and thyroid parameters. The average serum lithium level was 0.98 ± 0.31 mEq/L. Normal renal function (eGFR > 90mL/min -1.73m²) was seen in the vast majority of patients (93%), and 6.9% of patients had reduced eGFR. The incidence of thyroid dysfunction (both overt and subclinical hypothyroidism) was increased in patients who had higher doses of lithium.ECG abnormalities were observed in 3.8% of participants. A mild positive correlation was noted between lithium dose and T3 levels (p = 0.0423), while other associations were not statistically significant. Chronic lithium therapy was largely safe under therapeutic monitoring, though thyroid dysfunction and mild toxicity were observed in a subset of patients. Regular biochemical and cardiac monitoring remains essential to ensure long-term safety.