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.