{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T20:39:47Z","timestamp":1792269587062,"version":"4.4.0"},"reference-count":33,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Human Psychopharmacology"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess early renal and lithium\u2010related safety and 12\u2010month renal biomarker trajectories after tirzepatide initiation in lithium\u2010treated adults with bipolar disorder.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively studied 23 adults at one centre. The principal 12\u2010week renal safety measures were serum creatinine and derived CKD\u2010EPI 2021 creatinine\u2010based eGFR. Secondary outcomes included lithium, electrolytes, gastrointestinal symptoms, acute kidney injury meeting KDIGO creatinine criteria and discontinuation. Twelve\u2010month trajectories and body\u2010surface\u2010area\u2010unindexed eGFR were exploratory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At 12\u00a0weeks, creatinine changed by \u22123\u00a0\u00b1\u00a012\u00a0\u03bcmol\/L (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.196), indexed eGFR by +2.6\u00a0\u00b1\u00a015.1\u00a0mL\/min\/1.73\u00a0m\n                      <jats:sup>2<\/jats:sup>\n                      (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.259) and lithium by +0.08\u00a0\u00b1\u00a00.17\u00a0mmol\/L (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.030). Among 20 on\u2010treatment completers at 12\u00a0months, weight decreased by 17.7\u00a0\u00b1\u00a06.0%, creatinine by 12\u00a0\u00b1\u00a09\u00a0\u03bcmol\/L, indexed eGFR increased by 13.0\u00a0\u00b1\u00a012.1\u00a0mL\/min\/1.73\u00a0m\n                      <jats:sup>2<\/jats:sup>\n                      and unindexed eGFR by 4.5\u00a0\u00b1\u00a014.3\u00a0mL\/min. Two patients had lithium &gt;\u00a01.2\u00a0mmol\/L; one developed clinician\u2010attributed symptomatic toxicity and discontinued tirzepatide. No acute kidney injury meeting KDIGO creatinine criteria could be confirmed from available records.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Co\u2010prescription warrants structured monitoring and sick\u2010day education. Creatinine\u2010based eGFR changes during major weight loss do not establish renal benefit or exclude kidney injury.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hup.70066","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T12:54:31Z","timestamp":1790600071000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Tirzepatide Initiation in Lithium\u2010Treated Bipolar Disorder: Renal Biomarker Trajectories and Lithium Safety Signals Over 12\u00a0Months in a Real\u2010World Cohort"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-8653-9504","authenticated-orcid":false,"given":"Maria Beatrice","family":"Rescalli","sequence":"first","affiliation":[{"name":"Division of Psychiatry, Department of Molecular Medicine University of Siena School of Medicine  Siena 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Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavia","family":"Castaldo","sequence":"additional","affiliation":[{"name":"Division of Psychiatry, Department of Molecular Medicine University of Siena School of Medicine  Siena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Cuomo","sequence":"additional","affiliation":[{"name":"Division of Psychiatry, Department of Molecular Medicine University of Siena School of Medicine  Siena 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