Bipolar disorder: Lithium protects against COVID

Lithium, in the form of salts, has been established since the 1970s as the main treatment for “mood stabilizers” (or mood regulators) in the treatment of bipolar disorder.

In this period of the pandemic, its anti-inflammatory and antiviral properties have sparked particular interest in the scientific community, reports Marion Leboir, professor of psychiatry (Hôpitaux Henri Mondor, Université Paris Est Créteil, Inserm) on the site France Conversation.

Lithium salts are used to treat episodes of depression or mania from bipolar disorder and to prevent relapses. Its beneficial role in neuronal plasticity stems from its ability to improve communication between neurons.

Antiviral effect of lithium

Several studies have indicated that lithium salts can inhibit the replication cycle of many viruses, including some coronaviruses, according to the professor. As early as 1979, researchers showed that herpes virus-infected bipolar patients treated with lithium showed signs of clinical remission.

The latest data indicate that the antiviral effect of lithium is particularly noticeable on RNA and DNA viruses.

Possible antiviral effect of some antidepressants

Several works published since the beginning of the epidemic have reported a potential protective effect of several antidepressants, including fluoxetine (Prozac) and fluvoxamine (Luvox). However, scientific data is still insufficient, and the French Medicines Agency is currently excluding fluvoxamine from the therapeutic arsenal in the fight against the Corona virus.

Other works appear to show negative effects of other treatments (eg clozapine, an antipsychotic used in schizophrenia, which appears to worsen the prognosis in the case of COVID).

reduced risk

Ms Leboer’s team work published in March 2022 in British Journal of Psychiatryis the first to provide conclusive, real-life data indicating that lithium intake at therapeutic doses is associated with a reduced risk of infection.

The team studied data from 26,554 people, drawn from a large, anonymous US database. They had information on these people regarding blood lithium levels as well as COVID-19 diagnoses and/or PCR test results.

People taking lithium were less likely to get COVID-19 and have a positive PCR test. This is regardless of whether they are diagnosed with a mental disorder or if they are vaccinated.

However, the sample of subjects treated with lithium was too small to determine whether the drug had a beneficial effect in reducing the risk of severe forms in patients infected with SARS-CoV-2. However, a lower incidence of disease as found in the study is likely to be associated with a lower risk of complications.

Explanation of the phenomenon

The mechanisms explaining the antiviral effects of lithium have not been elucidated. However, some indications appear: laboratory studies have indicated that this drug inhibits the replication of the RNA of the virus.

The researchers also found that the effects of lithium are particularly strong on SARS-CoV-2 but less on other respiratory viruses: suggesting biological mechanisms specific to this coronavirus.

If lithium cannot be repositioned as a drug available to the general public to fight COVID-19, due to these side effects (hypothyroidism, tremors, kidney problems, etc.)“, these “The results must be weighed in the balance as the clinician weighs the risks and benefits of prescribing this treatment to patients with bipolar disorder, especially those who are fragile in a pandemic.The researcher concludes. (Lithium side effects and recommendations, based on an analysis of 400 studies)

For more information on bipolar disorder, see the links below.

See also:

psychology With sources: The Conservation France, British Journal of Psychiatry.
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