Lithium in cardiovascular health and disease: Pharmacological and clinical implications.

Lithium, a cornerstone therapy for bipolar disorder (BD), produces complex and dual effects on cardiovascular health. This review synthesizes current evidence on the direct and indirect cardiovascular effects of lithium. Direct effects include dose-dependent influences on cardiac development, hypertrophy, fibrosis, mitochondrial function, and arrhythmia. While therapeutic doses may confer cardioprotective benefits by inhibiting GSK-3β, which activates the Wnt/β-catenin signaling pathway and modulates anti-inflammatory pathways, supratherapeutic levels exacerbate oxidative stress, mitochondrial dysfunction, and arrhythmogenicity. Indirectly, lithium modulates cardiovascular outcomes caused by renal dysfunction, metabolic syndrome, and neuroendocrine-immune interactions. Clinical studies suggested that there is reduced cardiovascular mortality in lithium-treated BD patients, potentially offsetting its adverse metabolic effects. However, conflicting evidence persists, particularly regarding dose specificity and long-term outcomes. Future research should focus on high-quality clinical trials to clarify the balance between therapeutic benefits and adverse effects of lithium to ensure its safe and effective use in clinical practice.

• Publication year

  2025

• Venue

  European Journal of Pharmacology

• Publication date

  2025-05-01

• Fields of study

  Medicine

• Identifiers
  DOI 10.1016/j.ejphar.2025.177657PMID 40324573
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

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