title: The Lithium Battery: assessing the neurocognitive profile of lithium in bipolar disorder.
abstract: OBJECTIVE
  The aim of the present study was to characterize the neurocognitive effects of lithium in bipolar disorder to inform clinical and research approaches for further investigation.
  
  
  METHODS
  Key words pertaining to neurocognition in bipolar disorder and lithium treatment were used to search recognized databases to identify relevant literature. The authors also retrieved gray literature (e.g., book chapters) known to them and examined pertinent articles from bibliographies.
  
  
  RESULTS
  A limited number of studies have examined the effects of lithium on neurocognition in bipolar disorder and, although in some domains a consistent picture emerges, in many domains the findings are mixed. Lithium administration appears to reshape key components of neurocognition - in particular, psychomotor speed, verbal memory, and verbal fluency. Notably, it has a sophisticated neurocognitive profile, such that while lithium impairs neurocognition across some domains, it seemingly preserves others - possibly those vulnerable to the effects of bipolar disorder. Furthermore, its effects are likely to be direct and indirect (via mood, for example) and cumulative with duration of treatment. Disentangling the components of neurocognition modulated by lithium in the context of a fluctuating and complex illness such as bipolar disorder is a significant challenge but one that therefore demands a stratified and systematic approach, such as that provided by the Lithium Battery.
  
  
  CONCLUSIONS
  In order to delineate the effects of lithium therapy on neurocognition in bipolar disorder within both research and clinical practice, a greater understanding and measurement of the relatively stable neurocognitive components is needed to examine those that indeed change with lithium treatment. In order to achieve this, we propose a Lithium Battery-Clinical and a Lithium Battery-Research that can be applied to these respective settings.
authors.affiliation: Academic Department of Psychiatry, Kolling Institute, Northern Sydney Local Health District, St. Leonards, Sydney, NSW, Australia.|Sydney Medical School Northern, The University of Sydney, Sydney, NSW, Australia.|CADE Clinic, Royal North Shore Hospital, Sydney, NSW, Australia.
authors.forename: Gin S
authors.initials: GS
authors.lastname: Malhi
authors.affiliation: Academic Department of Psychiatry, Kolling Institute, Northern Sydney Local Health District, St. Leonards, Sydney, NSW, Australia.|Sydney Medical School Northern, The University of Sydney, Sydney, NSW, Australia.|CADE Clinic, Royal North Shore Hospital, Sydney, NSW, Australia.
authors.forename: Claire
authors.initials: C
authors.lastname: McAulay
authors.affiliation: Emeritus Professor of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.|Mind and Brain Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia.
authors.forename: Samuel
authors.initials: S
authors.lastname: Gershon
authors.affiliation: Academic Department of Psychiatry, Kolling Institute, Northern Sydney Local Health District, St. Leonards, Sydney, NSW, Australia.|Sydney Medical School Northern, The University of Sydney, Sydney, NSW, Australia.|CADE Clinic, Royal North Shore Hospital, Sydney, NSW, Australia.
authors.forename: Danielle
authors.initials: D
authors.lastname: Gessler
authors.affiliation: Academic Department of Psychiatry, Kolling Institute, Northern Sydney Local Health District, St. Leonards, Sydney, NSW, Australia.|Sydney Medical School Northern, The University of Sydney, Sydney, NSW, Australia.|CADE Clinic, Royal North Shore Hospital, Sydney, NSW, Australia.
authors.forename: Kristina
authors.initials: K
authors.lastname: Fritz
authors.affiliation: Academic Department of Psychiatry, Kolling Institute, Northern Sydney Local Health District, St. Leonards, Sydney, NSW, Australia.|Sydney Medical School Northern, The University of Sydney, Sydney, NSW, Australia.|CADE Clinic, Royal North Shore Hospital, Sydney, NSW, Australia.
authors.forename: Pritha
authors.initials: P
authors.lastname: Das
authors.affiliation: Academic Department of Psychiatry, Kolling Institute, Northern Sydney Local Health District, St. Leonards, Sydney, NSW, Australia.|Sydney Medical School Northern, The University of Sydney, Sydney, NSW, Australia.|CADE Clinic, Royal North Shore Hospital, Sydney, NSW, Australia.
authors.forename: Tim
authors.identifier: http://orcid.org/0000-0003-2534-3635
authors.initials: T
authors.lastname: Outhred
mesh_terms: D001714:Bipolar Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology / Q000523:psychology; D003071:Cognition / Q000187:drug effects; D006801:Humans; D008094:Lithium / Q000494:pharmacology*; D054539:Medication Therapy Management; D008568:Memory / Q000187:drug effects; D009483:Neuropsychological Tests; D011597:Psychomotor Performance / Q000187:drug effects
chemical_list: D008094:Lithium
keywords: assessment; bipolar disorder; cognition; lithium; neurocognition; psychomotor speed; verbal fluency; verbal memory