Lithium in Bipolar Disorder: A Systematic Review of Dosing Frequency, Renal Effects, and Nephrotoxicity Mechanisms
Abdel-Aziz Gamal Farrag
STEM High School for Boys-6th of October, Giza, Egypt
Publication date: November 20, 2025
STEM High School for Boys-6th of October, Giza, Egypt
Publication date: November 20, 2025
DOI: http://doi.org/10.34614/JIYRC2025II58
ABSTRACT
Bipolar disorder is a serious problem affecting up to 1% of the world’s population. Lithium, a gold standard for reducing bipolar symptoms, is an effective treatment but is associated with renal complications. The severity of lithium’s side effects correlates with serum concentration, indicating that the dosing regimen might have a significant role. This study was conducted to investigate the renal differences across different dosing regimens. A PRISMA search process was conducted, databases such as PubMed and ScienceDirect were accessed, and using some keywords combined with Boolean operators, seven studies were included. MDD groups showed higher urine output and greater histopathological changes than SDD groups. Additionally, an increased daily dose was accompanied by a urine output increase, showing a decreased ability of the kidneys to concentrate urine. Finally, the prolonged-release formulation had a reduced negative effect on the kidney’s urine-concentrating ability. Further high-quality studies are needed to establish reliable dosing recommendations.
Bipolar disorder is a serious problem affecting up to 1% of the world’s population. Lithium, a gold standard for reducing bipolar symptoms, is an effective treatment but is associated with renal complications. The severity of lithium’s side effects correlates with serum concentration, indicating that the dosing regimen might have a significant role. This study was conducted to investigate the renal differences across different dosing regimens. A PRISMA search process was conducted, databases such as PubMed and ScienceDirect were accessed, and using some keywords combined with Boolean operators, seven studies were included. MDD groups showed higher urine output and greater histopathological changes than SDD groups. Additionally, an increased daily dose was accompanied by a urine output increase, showing a decreased ability of the kidneys to concentrate urine. Finally, the prolonged-release formulation had a reduced negative effect on the kidney’s urine-concentrating ability. Further high-quality studies are needed to establish reliable dosing recommendations.
