Lithium-associated hypercalcemia and hyperparathyroidism in the elderly: What do we know?

Susan W. Lehmann, Janet Lee

Research output: Contribution to journalReview articlepeer-review

Abstract

Background: Lithium has been reported to induce hypercalcemia and hyperparathyroidism, yet few studies have examined the impact on older patients. We therefore undertook this review and report our findings. Method: We undertook a systematic review of articles on lithium-associated hypercalcemia and/or hyperparathyroidism that were identified via electronic English language database searches through PubMed. Results: Among reported cases and case series of lithium-associated hyperparathyroidism in which ages of specific subjects were provided, 40% of affected individuals were over age 60. Mean serum calcium levels are reported to be higher in lithium treated patients over age 60 compared with younger patients. While many patients who develop lithium-associated hypercalcemia and hyperparathyroidism are asymptomatic, symptomatic complications may be more of a concern in older patients, especially in those with co-morbid renal disease. Limitations: To date, all cross-sectional studies of lithium-associated hypercalcemia and hyperparathyroidism are of mixed age group cohorts and more specific studies focused on older patients have yet to be performed. Conclusions: Lithium-induced hypercalcemia and hyperparathyroidism are under-recognized potential complications of lithium therapy which may occur more frequently in older patients. Psychiatrists should be vigilant in screening for hypercalcemia and hyperparathyroidism in their older patients receiving lithium, both prior to starting treatment and at least annually thereafter.

Original languageEnglish (US)
Pages (from-to)151-157
Number of pages7
JournalJournal of Affective Disorders
Volume146
Issue number2
DOIs
StatePublished - Apr 5 2013

Keywords

  • Bipolar disorder
  • Elderly
  • Hypercalcemia
  • Hyperparathyroidism
  • Lithium

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

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