title: Lithium-associated hypercalcemia and hyperparathyroidism in the elderly: what do we know?
abstract: BACKGROUND
  Lithium has been reported to induce hypercalcemia and hyperparathyroidism, yet few studies have examined the impact on older patients. We therefore undertook this review and report our findings.
  
  
  METHODS
  We undertook a systematic review of articles on lithium-associated hypercalcemia and/or hyperparathyroidism that were identified via electronic English language database searches through PubMed.
  
  
  RESULTS
  Among reported cases and case series of lithium-associated hyperparathyroidism in which ages of specific subjects were provided, 40% of affected individuals were over age 60. Mean serum calcium levels are reported to be higher in lithium treated patients over age 60 compared with younger patients. While many patients who develop lithium-associated hypercalcemia and hyperparathyroidism are asymptomatic, symptomatic complications may be more of a concern in older patients, especially in those with co-morbid renal disease.
  
  
  CONCLUSIONS
  To date, all cross-sectional studies of lithium-associated hypercalcemia and hyperparathyroidism are of mixed age group cohorts and more specific studies focused on older patients have yet to be performed.
  
  
  CONCLUSIONS
  Lithium-induced hypercalcemia and hyperparathyroidism are under-recognized potential complications of lithium therapy which may occur more frequently in older patients. Psychiatrists should be vigilant in screening for hypercalcemia and hyperparathyroidism in their older patients receiving lithium, both prior to starting treatment and at least annually thereafter.
authors.affiliation: The Johns Hopkins University School of Medicine, 600 North Wolfe Street, Meyer 279, Baltimore, Maryland 21287-7279, United States. slehman@jhmi.edu
authors.forename: Susan W
authors.initials: SW
authors.lastname: Lehmann
authors.forename: Janet
authors.initials: J
authors.lastname: Lee
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D006801:Humans; D006934:Hypercalcemia / Q000139:chemically induced*; D006961:Hyperparathyroidism / Q000139:chemically induced*; D008094:Lithium / Q000009:adverse effects*
chemical_list: D008094:Lithium