Abstract
Lithium is a well-known FDA-approved treatment for bipolar and mood disorders. Lithium has been an enigmatic drug with multifaceted actions involving various neurotransmitters and intricate cell signalling cascades. Recent studies highlight the neuroprotective and neurotrophic actions of lithium in amyotrophic lateral sclerosis, Alzheimer’s disease, intracerebral hemorrhage, and epilepsy. Of note, lithium holds a significant interest in epilepsy, where the past reports expose its non-specific proconvulsant action, followed lately by numerous studies for anti-convulsant action. However, the exact mechanism of action of lithium for any of its effects is still largely unknown. The present review integrates findings from several reports and provides detailed possible mechanisms of how a single molecule exhibits marked pro-epileptogenic as well as anti-convulsant action. This review also provides clarity regarding the safety of lithium therapy in epileptic patients.
Keywords: Lithium, seizures, epilepsy, lithium-pilocarpine model, inflammation, glycogen synthase kinase-3β (GSK-3β).
Graphical Abstract
[http://dx.doi.org/10.1016/0006-3223(87)90026-6] [PMID: 3117123]
[http://dx.doi.org/10.1176/ajp.125.10.1446] [PMID: 4975138]
[http://dx.doi.org/10.1111/j.1399-5618.2009.00706.x] [PMID: 19538681]
[http://dx.doi.org/10.3390/ijms19072143] [PMID: 30041458]
[http://dx.doi.org/10.1186/s40345-019-0151-2] [PMID: 31328245]
[http://dx.doi.org/10.1080/j.1440-1614.2006.01808.x]
[http://dx.doi.org/10.3109/00048678209159969] [PMID: 6758755]
[http://dx.doi.org/10.5694/j.1326-5377.1951.tb68249.x] [PMID: 14881840]
[http://dx.doi.org/10.1001/archpsyc.1967.01730200030005] [PMID: 6019331]
[http://dx.doi.org/10.1192/bjp.116.535.604] [PMID: 4916293]
[http://dx.doi.org/10.3233/JAD-190197] [PMID: 31156173]
[http://dx.doi.org/10.3389/fnins.2015.00403] [PMID: 26578864]
[http://dx.doi.org/10.1016/j.ejphar.2018.10.019] [PMID: 30336136]
[http://dx.doi.org/10.1016/j.eplepsyres.2018.07.021] [PMID: 30096484]
[http://dx.doi.org/10.1021/cn5000309] [PMID: 24766396]
[http://dx.doi.org/10.1177/2045125312471963] [PMID: 24167688]
[http://dx.doi.org/10.3390/ijms22083908] [PMID: 33918982]
[http://dx.doi.org/10.1007/s00232-017-9998-2] [PMID: 29127487]
[http://dx.doi.org/10.2165/00023210-200923050-00004] [PMID: 19453201]
[http://dx.doi.org/10.4103/0019-5545.37325] [PMID: 20661390]
[http://dx.doi.org/10.1111/j.1528-1167.2005.463009.x] [PMID: 15938709]
[http://dx.doi.org/10.1016/j.yebeh.2006.06.016] [PMID: 16887395]
[http://dx.doi.org/10.1016/j.yebeh.2016.03.022] [PMID: 27236241]
[http://dx.doi.org/10.1093/omcr/omw089] [PMID: 28031853]
[http://dx.doi.org/10.3109/02699058809150900] [PMID: 3144406]
[http://dx.doi.org/10.1176/jnp.17.1.20] [PMID: 15746479]
[http://dx.doi.org/10.1053/ajem.2002.34957] [PMID: 12369038]
[http://dx.doi.org/10.1046/j.1440-1614.2001.0971a.x] [PMID: 11990898]
[http://dx.doi.org/10.1007/s10072-006-0530-1] [PMID: 16601939]
[http://dx.doi.org/10.4088/PCC.11r01197] [PMID: 22690368]
[http://dx.doi.org/10.3969/J.ISSN.1002-0829.2014.04.009] [PMID: 25317012]
[http://dx.doi.org/10.1016/j.jneumeth.2008.04.019] [PMID: 18550176]
[http://dx.doi.org/10.1007/s10787-020-00782-8] [PMID: 33386490]
[http://dx.doi.org/10.1038/s41398-021-01399-3]
[http://dx.doi.org/10.1038/nature15526]
[http://dx.doi.org/10.1016/j.nbd.2008.10.002] [PMID: 19010416]
[http://dx.doi.org/10.1111/j.1528-1167.2007.01300.x] [PMID: 17910592]
[http://dx.doi.org/10.1111/j.1528-1167.2011.03034.x] [PMID: 21542844]
[http://dx.doi.org/10.1111/j.1460-9568.2008.06070.x] [PMID: 18333967]
[http://dx.doi.org/10.1073/pnas.94.24.13311] [PMID: 9371842]
[http://dx.doi.org/10.1016/S0079-6123(08)62414-0]
[http://dx.doi.org/10.1111/jnc.12787] [PMID: 24909269]
[http://dx.doi.org/10.1016/0014-2999(91)90481-5] [PMID: 1651249]
[http://dx.doi.org/10.1093/ijnp/pyv118] [PMID: 26475745]
[http://dx.doi.org/10.1016/0022-3956(86)90019-1] [PMID: 3712294]
[http://dx.doi.org/10.3389/fnmol.2019.00208] [PMID: 31507376]
[http://dx.doi.org/10.1111/j.1471-4159.1985.tb12886.x] [PMID: 2983019]
[http://dx.doi.org/10.1007/s007020050035] [PMID: 9588758]
[http://dx.doi.org/10.1038/tp.2016.217] [PMID: 27922641]
[http://dx.doi.org/10.1007/BF02246978] [PMID: 7870890]
[http://dx.doi.org/10.1016/j.neubiorev.2007.05.001] [PMID: 17602744]
[http://dx.doi.org/10.1046/j.1460-9568.2003.02588.x] [PMID: 12713643]
[http://dx.doi.org/10.1111/j.1528-1167.2012.03476.x]
[http://dx.doi.org/10.1016/j.lfs.2004.12.033] [PMID: 15936350]
[PMID: 16862242]
[http://dx.doi.org/10.1016/0091-3057(79)90067-4] [PMID: 482313]
[http://dx.doi.org/10.1111/j.1528-1167.2007.01185.x] [PMID: 17645533]
[http://dx.doi.org/10.1111/j.1528-1167.2011.03080.x] [PMID: 21627645]
[http://dx.doi.org/10.1016/j.neuropharm.2020.108357] [PMID: 33065166]
[http://dx.doi.org/10.1016/j.neuroscience.2007.10.037] [PMID: 18082973]
[http://dx.doi.org/10.1111/bdi.12962] [PMID: 32558151]
[http://dx.doi.org/10.1016/j.nbd.2015.02.029] [PMID: 25836421]
[http://dx.doi.org/10.1186/1756-0500-7-635] [PMID: 25214394]
[http://dx.doi.org/10.1089/cap.2013.0046] [PMID: 24828326]
[http://dx.doi.org/10.3727/096368909X471251] [PMID: 19523343]
[http://dx.doi.org/10.1016/j.neuroscience.2007.12.026] [PMID: 18291594]
[http://dx.doi.org/10.1021/cn500040g]
[http://dx.doi.org/10.1016/0065-2571(95)00021-6] [PMID: 8869749]
[http://dx.doi.org/10.1016/j.molbrainres.2004.12.018] [PMID: 15857686]
[http://dx.doi.org/10.1111/j.0013-9580.2004.02204.x] [PMID: 15230693]
[http://dx.doi.org/10.1111/jnc.13360] [PMID: 26365376]
[http://dx.doi.org/10.1016/j.bbalip.2009.03.009] [PMID: 19327408]
[http://dx.doi.org/10.1080/01616412.2022.2051131] [PMID: 35285418]
[http://dx.doi.org/10.1046/j.1471-4159.2003.01811.x] [PMID: 12787074]
[http://dx.doi.org/10.1080/14728222.2018.1526925] [PMID: 30244615]
[http://dx.doi.org/10.1006/bbrc.2000.4169] [PMID: 11162580]
[http://dx.doi.org/10.1073/pnas.96.15.8745] [PMID: 10411946]
[http://dx.doi.org/10.1172/JCI37873] [PMID: 20530871]
[http://dx.doi.org/10.1016/j.pneurobio.2006.07.006] [PMID: 16935409]
[http://dx.doi.org/10.1038/s41419-018-0963-5] [PMID: 30237424]
[http://dx.doi.org/10.1038/s41398-021-01492-7] [PMID: 34226487]
[http://dx.doi.org/10.1016/j.eplepsyres.2010.02.001] [PMID: 20304610]
[http://dx.doi.org/10.1016/j.pnpbp.2016.06.006] [PMID: 27328427]
[http://dx.doi.org/10.1038/npp.2010.41] [PMID: 20357761]
[http://dx.doi.org/10.1016/B978-0-12-814037-6.00006-9]
[http://dx.doi.org/10.3389/fnmol.2018.00425] [PMID: 30524233]
[http://dx.doi.org/10.1016/j.brainresbull.2017.10.015] [PMID: 29102713]
[http://dx.doi.org/10.1097/00004714-198806000-00009] [PMID: 3379144]
[http://dx.doi.org/10.1177/155005947700800106]
[http://dx.doi.org/10.1002/ccr3.1796] [PMID: 30455928]
[http://dx.doi.org/10.1001/archpsyc.1973.01750350026005] [PMID: 4573418]
[http://dx.doi.org/10.4196/kjpp.2017.21.1.125] [PMID: 28066149]
[http://dx.doi.org/10.1034/j.1399-5618.2002.40201.x] [PMID: 12071511]
[http://dx.doi.org/10.2147/NDT.S106479]
[http://dx.doi.org/10.3389/fncel.2015.00091] [PMID: 25852482]
[http://dx.doi.org/10.1046/j.0022-3042.2001.00728.x] [PMID: 11841566]
[http://dx.doi.org/10.1097/00001756-199806220-00031] [PMID: 9674597]
[http://dx.doi.org/10.1016/j.yebeh.2010.04.002] [PMID: 20605531]
[http://dx.doi.org/10.1016/j.tips.2011.03.006] [PMID: 21492946]
[http://dx.doi.org/10.1007/s002130100834] [PMID: 11685387]
[http://dx.doi.org/10.1016/j.pharmthera.2010.07.006] [PMID: 20705090]
[http://dx.doi.org/10.3390/ijms21030981] [PMID: 32024149]
[http://dx.doi.org/10.1016/j.yebeh.2013.06.007] [PMID: 23939034]
[PMID: 7073401]
[http://dx.doi.org/10.1016/j.brainres.2004.09.018] [PMID: 15533315]
[http://dx.doi.org/10.1016/j.neulet.2019.134349] [PMID: 31238129]
[http://dx.doi.org/10.1016/j.yebeh.2016.04.035] [PMID: 27232376]
[http://dx.doi.org/10.1007/s40263-013-0039-0] [PMID: 23371914]
[http://dx.doi.org/10.1016/j.pbb.2015.03.016] [PMID: 25824982]
[http://dx.doi.org/10.1016/j.bbamcr.2020.118745] [PMID: 32450268]
[http://dx.doi.org/10.3389/fncel.2020.00019] [PMID: 32256316]
[http://dx.doi.org/10.1002/syn.20681] [PMID: 19623530]
[http://dx.doi.org/10.1021/acschemneuro.8b00281] [PMID: 30351911]
[http://dx.doi.org/10.1016/j.brainres.2004.08.021] [PMID: 15476703]
[http://dx.doi.org/10.1038/cddis.2010.33] [PMID: 21364661]
[http://dx.doi.org/10.1158/0008-5472.CAN-06-2740] [PMID: 17145862]
[http://dx.doi.org/10.1002/2211-5463.12220] [PMID: 28593132]
[http://dx.doi.org/10.1016/j.eplepsyres.2018.07.002] [PMID: 30053675]
[http://dx.doi.org/10.1038/sj.mp.4002093]
[http://dx.doi.org/10.1111/j.1528-1167.2007.01055.x] [PMID: 17437412]
[http://dx.doi.org/10.1038/sj.tpj.6500400] [PMID: 16733521]
[http://dx.doi.org/10.1016/S0278-5846(84)80031-7] [PMID: 6435180]
[http://dx.doi.org/10.1111/j.1528-1157.1985.tb05712.x] [PMID: 4076072]
[http://dx.doi.org/10.1007/BF00216068] [PMID: 3146773]
[http://dx.doi.org/10.1016/0014-4886(91)90103-J] [PMID: 1847879]
[http://dx.doi.org/10.1101/2020.11.24.388470]