There were no serious adverse events specifically related to lithium therapy, but two events (one case of dehydration and one case of acute renal failure) involved medical considerations related to lithium therapy.
The only significant difference in medication use between the two groups pertained to second-generation antipsychotics. Patients who received adjunctive lithium were 15-20% less likely to receive a second-generation antipsychotic (SGA) over the course of the study. "Put another way, if you don’t use lithium in your practice, you are going to be 15-20% more likely to be prescribing SGAs," Dr. Thase noted.
He acknowledged certain limitations of LiTMUS, including the study’s silence on "the utility of higher doses of lithium or the merits of lithium at higher doses in patients taking simpler psychopharmacology regimens."
While LiTMUS found that the use of lithium as an adjunct "did not improve the simplicity of the treatment regiment, it didn’t increase it, either," Dr. Thase said. "So if you know doctors who say ‘I don’t use lithium because it’s too complicated,’ remind them that we did not find lithium complicated in this study.
"In fact ... lithium was associated with a clinically meaningful reduction in the use of SGAs, "which means that using it lead to less patient exposure to the newer generation antipsychotics.
Dr. Thase disclosed that he has received research funding from the Agency for Healthcare Research and Quality, Eli Lilly, Forest Pharmaceuticals, GlaxoSmithKline, the National Institute of Mental Health, Otsuka Pharmaceuticals, and Sepracor. He also has received honoraria or is on the scientific board of several pharmaceutical companies.