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Commentary on a recent review of lithium toxicity: what are its implications for clinical practice?

Overview of attention for article published in BMC Medicine, November 2012
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Title
Commentary on a recent review of lithium toxicity: what are its implications for clinical practice?
Published in
BMC Medicine, November 2012
DOI 10.1186/1741-7015-10-132
Pubmed ID
Authors

Bruno Müller-Oerlinghausen, Michael Bauer, Paul Grof

Abstract

A recent paper by McKnight et al. in The Lancet has provided the first formal meta-analysis of the more common adverse reactions to lithium. The authors analyzed 385 studies and focused mainly on the harmful effects of lithium on the kidney, the thyroid and parathyroid glands, body weight, skin and congenital malformations. Their contribution is important and welcome, but as a guide for practice, it needs to be complemented by other relevant observations and individual patient-focused perspectives.The findings from that meta-analysis somewhat underestimate the renal side-effects, and distort to some degree or exclude other adverse effects. The glomerular filtration rate is reduced but not more than 0 to 5 ml/min/year of observation; this may not fully reflect the present state of knowledge. A quarter of patients in the study had abnormalities of the thyroid and/or parathyroid gland, and lithium was found to increase body weight significantly less than did olanzapine. Unfortunately, the authors did not consider the observations from spontaneous reporting systems, which may have changed the picture.We feel that some specific limitations of the study were related to the inclusion of patients regardless of adequacy of treatment, quality of monitoring, drug combinations, age and sex, and stabilization response.

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 39 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 39 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 7 18%
Student > Doctoral Student 6 15%
Student > Postgraduate 6 15%
Student > Master 6 15%
Other 4 10%
Other 10 26%
Readers by discipline Count As %
Medicine and Dentistry 28 72%
Nursing and Health Professions 2 5%
Unspecified 2 5%
Neuroscience 2 5%
Psychology 2 5%
Other 3 8%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 02 November 2012.
All research outputs
#10,016,427
of 12,517,134 outputs
Outputs from BMC Medicine
#1,890
of 2,010 outputs
Outputs of similar age
#100,791
of 142,535 outputs
Outputs of similar age from BMC Medicine
#164
of 168 outputs
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We're also able to compare this research output to 168 others from the same source and published within six weeks on either side of this one. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.