Effect of lithium carbonate on oxidative stress in patients with bipolar disorder / 上海交通大学学报（医学版）

ABSTRACT

Objective • To explore the effect on oxidative stress status of lithium treatment in bipolar disorder patients. Methods • This was a case-control study of 61 patients with bipolar disorder (8 manic patients and 53 depressed patients) matched with 49 healthy volunteers from Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine. Patients with bipolar disorder were treated with lithium carbonate for 6 weeks. The 17 Hamilton Depression Rating Scale (HAMD-17), Young Mania Rating Scale (YMRS), Clinical Global Impression-Severity of Illness (CGI-SI) were used to assess the clinical outcomes at baseline and endpoint. The serum levels of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px) and malondialdehyde (MDA) were measured at baseline and endpoint. The oxidative stress status of the patients and controls was compared, as well as its change after lithium treatment. Results • In the patients with bipolar mania or bipolar depression, the level of SOD was lower (t=5.403, P=0.000) and the levels of GSH-Px and MDA were higher (t=8.371, P=0.000; t=6.063, P=0.000) than those of the normal population, and the level of CAT had no difference in these two groups. There was no difference in the four oxidative stress indicators between the manic state and the depressive state. There were significant differences in plasma GSH-Px and MDA contents after lithium treatment (t=4.352, P=0.000; t=2.720, P=0.009), while there was no significant difference in plasma SOD and CAT levels after lithium treatment. After treatment with lithium, MDA content in bipolar mania and bipolar depression decreased significantly (t=3.072, P=0.018; t=3.532, P=0.001), and that in the manic state decreased more. There was a significant decrease in GSH-Px level in bipolar depression (t=2.880, P=0.006). Conclusion • Oxidative stress injury exists in the patients with bipolar disorder. Lithium carbonate may adjust the imbalance of oxidative stress in these patients, and its effect in different disease states is slightly different.