Acute effects of lithium augmentation on the kidney in geriatric compared with non‐geriatric patients with treatment‐resistant depression

Acta Psychiatrica Scandinavica, vol. 147, pp. 267–275

Abstract

INTRODUCTION: Lithium augmentation (LA) of antidepressants is a first-line therapy option for treatment-resistant depression (TRD). Nevertheless, it is rarely used in geriatric patients mostly because of the fear of kidney toxicity. The purpose of this study is to investigate estimated glomerular filtration rate (eGFR) changes and number of acute kidney injuries (AKI) using LA in geriatric compared with non-geriatric patients. METHODS: = 172) at baseline and over 2-6 weeks of LA. We used linear mixed models to investigate changes in eGFR upon LA and assessed the number of AKIs, according to the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. RESULTS: Both age groups showed a significant eGFR decline over the course of treatment with lower eGFR in geriatric patients. The lithium serum level (interpretable as "effect of LA") had a significant effect on eGFR decline. Both effects (age group and lithium serum level) on eGFR decline did not influence each other, meaning the effect of LA on eGFR decline did not differ between age groups. Two AKIs were observed in the geriatric age group when serum lithium levels exceeded the therapeutic range of >0.8 mmol/L. CONCLUSION: This is the first study investigating eGFR change and AKI upon LA for TRD in geriatric compared with non-geriatric patients. Our data suggest that LA, as an effective treatment option in geriatric patients, should be closely monitored to avoid AKIs.

Authors 16

1. Sarah Luise Osterland

   Humboldt-Universität zu Berlin · Charité - Universitätsmedizin Berlin

   Affiliation as printed

   Department of Psychiatry and Psychotherapy Charité ‐ Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany

2. Mazda Adli

   Humboldt-Universität zu Berlin · Charité - Universitätsmedizin Berlin

   Affiliation as printed

   Department of Psychiatry and Psychotherapy Charité ‐ Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany

   Department of Psychiatry and Psychotherapy Fliedner Klinik Berlin Berlin Germany

   Department of Psychiatry and Psychotherapy Charité ‐ Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany

3. Turgay Saritas Aachen Division of Nephrology and Clinical Immunology Institute of Experimental Medicine and Systems Biology Institute of Experimental Medicine and Systems Biology Aachen Germany

   RWTH Aachen University · Universitätsklinikum Aachen

   Affiliation as printed

   Division of Nephrology and Clinical Immunology University Hospital RWTH Aachen Aachen Germany

   University Hospital RWTH Aachen, Institute of Experimental Medicine and Systems Biology Aachen Germany

   Division of Nephrology and Clinical Immunology, University Hospital RWTH Aachen, Aachen, Germany

   University Hospital RWTH Aachen, Institute of Experimental Medicine and Systems Biology, Aachen, Germany

4. Peter Schlattmann

   Jena University Hospital

   Affiliation as printed

   Department of Statistics, Informatics and Data Sciences Jena University Hospital Jena Germany

   Department of Statistics, Informatics and Data Sciences, Jena University Hospital, Jena, Germany

5. Joachim Behr

   Charité - Universitätsmedizin Berlin · University of Potsdam · Brandenburg University of Technology Cottbus-Senftenberg · Medizinische Hochschule Brandenburg Theodor Fontane

   Affiliation as printed

   Department of Psychiatry, Psychotherapy and Psychosomatics Brandenburg Medical School Theodor Fontane Neuruppin Germany

   Faculty of Health Sciences Brandenburg Joint Faculty of the University of Potsdam, Brandenburg University of Technology Cottbus‐Senftenberg and Brandenburg Medical School Potsdam Germany

   Research Department of Experimental and Molecular Psychiatry, Department of Psychiatry and Psychotherapy Charité ‐ Universitätsmedizin Berlin Berlin Germany

   Department of Psychiatry, Psychotherapy and Psychosomatics, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany

   Faculty of Health Sciences Brandenburg, Joint Faculty of the University of Potsdam, Brandenburg University of Technology Cottbus-Senftenberg and Brandenburg Medical School, Potsdam, Germany

6. Ronja Müller‐Mertel

   Medizinische Hochschule Brandenburg Theodor Fontane

   Affiliation as printed

   Department of Psychology ‐ Clinical Psychology and Psychotherapy Brandenburg Medical School Theodor Fontane Neuruppin Germany

   Department of Psychology - Clinical Psychology and Psychotherapy, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany

7. Kai Hoffmann

   Humboldt-Universität zu Berlin · Charité - Universitätsmedizin Berlin

   Affiliation as printed

   Department of Psychiatry and Psychotherapy Charité ‐ Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany

8. Thomas Josef Stamm

   Humboldt-Universität zu Berlin · Charité - Universitätsmedizin Berlin · Medizinische Hochschule Brandenburg Theodor Fontane

   Affiliation as printed

   Department of Psychiatry and Psychotherapy Charité ‐ Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany

   Department of Psychology ‐ Clinical Psychology and Psychotherapy Brandenburg Medical School Theodor Fontane Neuruppin Germany

   Department of Psychiatry and Psychotherapy Charité ‐ Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany

9. Tom Bschor

   Technische Universität Dresden

   Affiliation as printed

   Department of Psychiatry and Psychotherapy Technical University of Dresden Medical School Dresden Germany

   Department of Psychiatry and Psychotherapy, Technical University of Dresden Medical School, Dresden, Germany

10. Christoph Richter

    Humboldt-Universität zu Berlin · Charité - Universitätsmedizin Berlin · Vivantes Klinikum

    Affiliation as printed

    Department of Psychiatry and Psychotherapy Charité ‐ Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany

    Department of Psychiatry and Psychotherapy Vivantes Klinikum Kaulsdorf Berlin Germany

    Department of Psychiatry and Psychotherapy Charité ‐ Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany

11. Bruno Steinacher

    Vivantes Klinikum

    Affiliation as printed

    Department of Psychiatry and Psychotherapy Vivantes Auguste‐Viktoria‐Klinikum Berlin Germany

    Department of Psychiatry and Psychotherapy Vivantes Wenckebach‐Klinikum Berlin Germany

    Department of Psychiatry and Psychotherapy, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany

    Department of Psychiatry and Psychotherapy, Vivantes Wenckebach-Klinikum, Berlin, Germany

12. Maria‐Christiane Jockers‐Scherübl
    Affiliation as printed

    Department of Psychiatry Oberhavel Kliniken Hennigsdorf Germany

    Department of Psychiatry, Oberhavel Kliniken, Hennigsdorf, Germany

13. Stephan Köhler

    Humboldt-Universität zu Berlin · Charité - Universitätsmedizin Berlin

    Affiliation as printed

    Department of Psychiatry and Psychotherapy Charité ‐ Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany

14. Andreas Heinz

    Humboldt-Universität zu Berlin · Charité - Universitätsmedizin Berlin

    Affiliation as printed

    Department of Psychiatry and Psychotherapy Charité ‐ Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany

15. Roland Ricken

    Humboldt-Universität zu Berlin · Charité - Universitätsmedizin Berlin

    Affiliation as printed

    Department of Psychiatry and Psychotherapy Charité ‐ Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany

16. Pichit Buspavanich corresponding

    Charité - Universitätsmedizin Berlin · Stiftung Charité · University of Potsdam · Brandenburg University of Technology Cottbus-Senftenberg · Medizinische Hochschule Brandenburg Theodor Fontane

    Affiliation as printed

    Department of Psychiatry, Psychotherapy and Psychosomatics Brandenburg Medical School Theodor Fontane Neuruppin Germany

    Faculty of Health Sciences Brandenburg Joint Faculty of the University of Potsdam, Brandenburg University of Technology Cottbus‐Senftenberg and Brandenburg Medical School Potsdam Germany

    Research Unit Gender in Medicine, Department of Psychiatry and Psychotherapy, Institute of Sexology and Sexual Medicine Charité ‐ Universitätsmedizin Berlin Berlin Germany

    Department of Psychiatry, Psychotherapy and Psychosomatics, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany

    Faculty of Health Sciences Brandenburg, Joint Faculty of the University of Potsdam, Brandenburg University of Technology Cottbus-Senftenberg and Brandenburg Medical School, Potsdam, Germany