{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T13:11:55Z","timestamp":1790514715245,"version":"4.1.0"},"reference-count":55,"publisher":"Bentham Science Publishers Ltd.","issue":"6","content-domain":{"domain":["eurekaselect.com"],"crossmark-restriction":true},"short-container-title":["CN"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:sec>\n<jats:title>Background:<\/jats:title>\n<jats:p>Lithium is the standard treatment for bipolar disorders (BD) in adults. There\nis a dearth of data on its use in the pediatric age. This review aimed to investigate the use of lithium in\npediatric bipolar disorder (BD) and other externalizing childhood-related disorders.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods:<\/jats:title>\n<jats:p>We applied the Preferred Reporting Items for Systematic Reviews and Meta-analyses criteria\n(PRISMA) to identify randomized controlled trials evaluating the use of lithium in pediatric (BD),\nconduct disorder (CD), attention deficit hyperactivity disorder, oppositional defiant disorder, and disruptive\nmood dysregulation disorder. The primary outcome of our study was to evaluate the efficacy\nof lithium compared to a placebo or other pharmacological agents. The secondary outcomes were acceptability\nand tolerability.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results:<\/jats:title>\n<jats:p>Twelve studies were eligible, 8 on BD and 4 on CD. Overall, 857 patients were treated with\nlithium. No studies for externalizing disorder diagnoses were identified. Regarding BD patients\n(n = 673), efficacy results suggested that lithium was superior to placebo in manic\/mixed episodes but\ninferior to antipsychotics. Lithium efficacy ranged from 32% to 82.4%. Results on maintenance need\nto be expanded. Comorbidity rates with other externalizing disorders were extremely high, up to\n98.6%. Results in CD patients (n= 184) suggested the efficacy of lithium, especially for aggressive behaviors.\nNo severe adverse events directly related to lithium were reported in BD and CD; common\nside effects were similar to adults.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions:<\/jats:title>\n<jats:p>This systematic review supports the use of lithium in BD and CD as an efficacious and\ngenerally well\u2010tolerated treatment in the pediatric age. However, evidence is limited due to the paucity\nof available data.<\/jats:p>\n<\/jats:sec>","DOI":"10.2174\/1570159x21666230126153105","type":"journal-article","created":{"date-parts":[[2023,1,27]],"date-time":"2023-01-27T06:52:58Z","timestamp":1674802378000},"page":"1329-1342","update-policy":"https:\/\/doi.org\/10.2174\/bsp_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Use of Lithium in Pediatric Bipolar Disorders and Externalizing Childhood-\nrelated Disorders: A Systematic Review of Randomized Controlled\nTrials"],"prefix":"10.2174","volume":"21","author":[{"given":"Delfina","family":"Janiri","sequence":"first","affiliation":[{"name":"Department of Geriatrics, Institute of Psychiatry and Psychology, Neuroscience and Orthopedics, Catholic University\nof the Sacred Heart, Largo Francesco Vito 1, Rome, 00168, Italy"},{"name":"Department of Psychiatry, Fondazione Policlinico\nUniversitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 1, Rome, 00168, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Moccia","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Institute of Psychiatry and Psychology, Neuroscience and Orthopedics, Catholic University\nof the Sacred Heart, Largo Francesco Vito 1, Rome, 00168, Italy"},{"name":"Department of Psychiatry, Fondazione Policlinico\nUniversitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 1, Rome, 00168, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Montanari","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Institute of Psychiatry and Psychology, Neuroscience and Orthopedics, Catholic University\nof the Sacred Heart, Largo Francesco Vito 1, Rome, 00168, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Zani","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Institute of Psychiatry and Psychology, Neuroscience and Orthopedics, Catholic University\nof the Sacred Heart, Largo Francesco Vito 1, Rome, 00168, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Prinari","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Institute of Psychiatry and Psychology, Neuroscience and Orthopedics, Catholic University\nof the Sacred Heart, Largo Francesco Vito 1, Rome, 00168, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Monti","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Institute of Psychiatry and Psychology, Neuroscience and Orthopedics, Catholic University\nof the Sacred Heart, Largo Francesco Vito 1, Rome, 00168, Italy"},{"name":"UOS Clinical Psychology, Clinical\nGovernment, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 1, 00168,\nRome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Chieffo","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Institute of Psychiatry and Psychology, Neuroscience and Orthopedics, Catholic University\nof the Sacred Heart, Largo Francesco Vito 1, Rome, 00168, Italy"},{"name":"UOS Clinical Psychology, Clinical\nGovernment, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 1, 00168,\nRome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianna","family":"Mazza","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Institute of Psychiatry and Psychology, Neuroscience and Orthopedics, Catholic University\nof the Sacred Heart, Largo Francesco Vito 1, Rome, 00168, Italy"},{"name":"Department of Psychiatry, Fondazione Policlinico\nUniversitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 1, Rome, 00168, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessio","family":"Simonetti","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Institute of Psychiatry and Psychology, Neuroscience and Orthopedics, Catholic University\nof the Sacred Heart, Largo Francesco Vito 1, Rome, 00168, Italy"},{"name":"Department of Psychiatry, Fondazione Policlinico\nUniversitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 1, Rome, 00168, Italy"},{"name":"Centro Lucio Bini, Via Crescenzio 42, Rome, 00193, Italy"},{"name":"Menninger Department of Psychiatry and Behavioral\nSciences, Baylor College of Medicine, 1 Baylor Plaza, Houston, 77030, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios D.","family":"Kotzalidis","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Institute of Psychiatry and Psychology, Neuroscience and Orthopedics, Catholic University\nof the Sacred Heart, Largo Francesco Vito 1, Rome, 00168, Italy"},{"name":"Department of Psychiatry, Fondazione Policlinico\nUniversitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 1, Rome, 00168, Italy"},{"name":"Centro Lucio Bini, Via Crescenzio 42, Rome, 00193, Italy"},{"name":"NESMOS Department, La\nSapienza, Faculty of Medicine and Psychology, Sant\u2019Andrea University Hospital, University of Rome, Via di Grottarossa,\n1035-1039, Rome, 00189, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Janiri","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Institute of Psychiatry and Psychology, Neuroscience and Orthopedics, Catholic University\nof the Sacred Heart, Largo Francesco Vito 1, Rome, 00168, Italy"},{"name":"Department of Psychiatry, Fondazione Policlinico\nUniversitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 1, Rome, 00168, 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