Lithium & Weight Gain

Every study in this review that reports body weight, BMI, or a weight-related adverse event in people taking lithium — related where possible to elemental dose and achieved serum level.

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Rate of weight change vs elemental lithium dose

12 lithium arms reporting a kg change from baseline, a treatment length, and a daily dose. Rate = reported change ÷ weeks of treatment.

One point per lithium arm. No study reports elemental lithium directly — every dose here is converted from the stated salt (carbonate is 18.8% lithium by mass). Studies shorter than 2 weeks are excluded — a one-week weight change is mostly fluid shift, not tissue. These are within-arm changes with no comparison group, so they show what patients on lithium experienced, not what lithium caused.

Rate of weight change vs achieved serum lithium

13 lithium arms reporting a kg change from baseline, a treatment length, and a measured serum level.

Serum levels are achieved measurements, never protocol targets. Points below the dashed line lost weight on lithium.

Total weight change vs elemental lithium dose

Same 12 arms as the rate chart, but showing the UN-normalized total kg change over each study's whole window.

Totals accrued over windows from 2 weeks to years, so treatment length (the point color) matters as much as dose here — the rate chart above is the duration-adjusted view of the same arms.

Total weight change vs achieved serum lithium

Same 13 arms as the rate chart, but showing the un-normalized total kg change over each study's whole window.

Serum levels are achieved measurements, never protocol targets. Totals are not duration-adjusted — see the rate chart for the per-week view.

Total weight change vs cumulative lithium exposure

12 lithium arms where dose × duration is computable. Cumulative exposure = mean daily elemental dose × days on treatment.

Cumulative exposure = mean daily elemental dose × days on treatment, so a point far to the right can be a modest dose held for years.

Total weight change vs length of treatment

36 lithium arms with a kg change and a known observation window — the raw time course behind the rates above.

If lithium weight gain accrues early and then plateaus — the common clinical claim — points should rise across the first months and flatten to the right. Very short studies (< 2 weeks) appear here even though they are excluded from the rate charts.

How often patients on lithium gained weight

47 lithium arms reporting the number or percentage of patients with weight gain, binned by incidence.

Definitions vary widely — a formal “≥7% of body weight” threshold and a spontaneously reported adverse event are not the same bar — so this shows the spread of reported incidences, not one pooled rate. Drinking-water, supplement and anorexia-treatment strata are excluded.

Weight-gain incidence vs elemental lithium dose

17 lithium arms reporting how many patients gained weight, against the arm's daily elemental dose.

Incidence definitions vary by study (legend), so vertical spread here partly reflects definition rather than biology — compare points of one color. Drinking-water, supplement and anorexia-treatment strata are excluded.

Weight-gain incidence vs cumulative lithium exposure

9 lithium arms with an incidence, a daily dose and a treatment length. Cumulative exposure = mean daily elemental dose × days.

The fraction of an arm reporting weight gain as an adverse event, against total lithium ingested. Longer studies accumulate both more exposure and more chances to record the event — time on the x-axis is also time at risk, so a rightward rise would need cautious reading.

showing 100 of 135 studies


Response and Adverse Effects to Lithium Treatment in Patients With Bipolar Disorder at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia. Hailu AE et al.. BioMed research international 2026(1) e8884457. (2026)	Retrospective Cohort	Bipolar unspecified	In-/outpatient	262	—	—	26.0 wk	Weight gain (patient-reported adverse effect) % gaining ≥7%	—	therapeutic	Serious
Effect of psychopharmacological combinations on psychopathological symptom burden and BMI trajectories in patients with eating disorders. Panarello E. et al.. Frontiers in psychiatry 17 1750187. (2026)	Prospective Cohort	Other	Inpatient	127	—	—	10.0 wk	Change in Body Mass Index (DBMI) over ten-week inpatient treatment BMI change	-1.70 BMI change [-3.17, -0.23] p 0.023	anorexia tx	Serious
Demographic and Clinical Correlates of Body Mass Index in Older Age Bipolar Disorder: Results from the GAGE-BD Project. Chan CK et al.. Medicina (Kaunas, Lithuania) 62(4). (2026)	Cross Sectional	Bipolar unspecified	Outpatient	1,226	—	—	—	Body mass index (BMI, kg/m2) associated with lithium use BMI	-0.37 BMI [-0.63, -0.12] p 0.005	therapeutic	Serious
A Survey Exploring People's Experiences With Lithium Bought as a Supplement: Une enquête sur l'expérience des personnes avec le lithium en supplément. Strawbridge R. et al.. Canadian journal of psychiatry. Revue canadienne de psychiatrie 70(10) 782-795. (2025)	Cross Sectional	Other	Community	211	—	—	19.3 wk	Weight side effect / weight change reported by lithium supplement users	—	supplement	Critical
Efficacy and Safety of Adjunctive Aripiprazole LAI or Paliperidone LAI for the Management of Patients Suffering from Bipolar I Disorder with Comorbid Obsessive-Compulsive Disorder. Martiadis V. et al.. Journal of clinical medicine 14(3). (2025)	Retrospective Cohort	Bipolar I	Community	27	—	—	24.0 wk	Body weight (BW) change, PP-LAI vs ARI-LAI groups (mood stabilizer subgroup includes lithium and valproate patients combined; lithium not separately reported for this outcome) kg change	—	therapeutic	Serious
Psychotropic drug-induced adverse drug reactions in 462,661 psychiatric inpatients in relation to age: results from a German drug surveillance program from 1993-2016. Seifert J. et al.. Annals of general psychiatry 23(1) 47. (2024)	Retrospective Cohort	Other	Inpatient	462,661	127 mg elem./day	—	—	Changes in body weight (weight gain) as an adverse drug reaction, ≥65 vs <65 years, all psychotropic drugs combined	0.07 [0.04, 0.14] p —	therapeutic	Serious
Predicting maintenance lithium response for bipolar disorder from electronic health records-a retrospective study. Hayes JF et al.. PeerJ 12 e17841. (2024)	Retrospective Cohort	Bipolar unspecified	—	31,518	—	—	104 wk	Overweight or obese status (baseline characteristic, not a treatment-emergent weight outcome)	—	therapeutic	Serious
Mega-analysis of association between obesity and cortical morphology in bipolar disorders: ENIGMA study in 2832 participants. McWhinney SR et al.. Psychological medicine 53(14) 6743-6753. (2023)	Cross Sectional	Bipolar unspecified	Outpatient	2,832	—	—	—	Body mass index (BMI) association with current lithium treatment (all BD participants) BMI	—	therapeutic	Serious
The Role of Mood Stabilizers in Children and Adolescents with Anorexia Nervosa: A 1-year Follow-Up, Propensity Score-Matched Study. Pruccoli J. et al.. Pharmacopsychiatry 56(3) 118-125. (2023)	Retrospective Cohort	Other	—	234	—	—	18.0 wk	BMI change (admission to discharge) BMI change	—	therapeutic	Serious
Preliminary results from the Australian Genetics of Bipolar Disorder Study: A nation-wide cohort. Lind PA et al.. The Australian and New Zealand journal of psychiatry 57(11) 1428-1442. (2023)	Cross Sectional	Bipolar unspecified	—	6,682	—	—	—	Weight gain reported as an adverse drug reaction (ever experienced, lithium users)	—	therapeutic	Critical
Lithium Pharmacokinetics in the Perinatal Patient With Bipolar Disorder. Clark CT et al.. Journal of clinical pharmacology 62(11) 1385-1392. (2022)	Prospective Cohort	Bipolar I	Outpatient	4	155 mg~ elem./day 0.53 mmol/L	low	—	Body mass index (BMI) change from baseline to end of pregnancy BMI change	—	therapeutic	Serious
Dose-dependent transcriptional effects of lithium and adverse effect burden in a psychiatric cohort. Krull F. et al.. Progress in neuro-psychopharmacology & biological psychiatry 112 110408. (2022)	Cross Sectional	Other	In-/outpatient	1,450	—	—	—	Weight gain (UKU adverse effect item) association with lithium-associated gene expression (LAMTOR1/LAMTOR4)	—	therapeutic	Serious
Lithium use during breastfeeding was safe in healthy full-term infants under strict monitoring. Heinonen E. et al.. Acta paediatrica (Oslo, Norway : 1992) 111(10) 1891-1898. (2022)	Retrospective Cohort	Bipolar unspecified	Outpatient	30	22.5 mg elem./day 0.60 mmol/L	medium	—	Inadequate infant growth (<15 g/day weight gain since last visit) % gaining ≥7%	—	low-dose clinical	Serious
Differences between bipolar disorder types 1 and 2 support the DSM two-syndrome concept. Tondo L. et al.. International journal of bipolar disorders 10(1) 21. (2022)	Cross Sectional	Bipolar unspecified	Outpatient	1,377	135 mg~ elem./day 0.58 mmol/L	low	—	Body-mass index (BMI) and obesity prevalence, BD-1 vs BD-2 (whole-cohort diagnostic comparison, not restricted to lithium users) BMI	0.70 BMI p 0.040 †	therapeutic	Serious
Exploring the Effects of Greek Yogurt Supplementation and Exercise Training on Serum Lithium and Its Relationship With Musculoskeletal Outcomes in Men. Baranowski RW et al.. Frontiers in nutrition 8 798036. (2021)	RCT	Healthy volunteers	—	30	—	—	12.0 wk	Body mass (kg) kg	0.40 kg p 0.930 †	drinking water	High
Tolerability of lithium: A naturalistic discontinuation study in older inpatients (≥60 years). Flapper M. et al.. International journal of geriatric psychiatry 36(8) 1231-1240. (2021)	Retrospective Cohort	Mixed mood disorder	Outpatient	135	—	—	78.0 wk	Weight gain as reason for lithium discontinuation	—	therapeutic	Serious
A GWAS top hit for circulating leptin is associated with weight gain but not with leptin protein levels in lithium-augmented patients with major depression. Bopp SK et al.. European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology 53 114-119. (2021)	Prospective Cohort	Unipolar depression (MDD)	—	180	—	—	30.0 wk	BMI (kg/m2) during lithium augmentation, modeled by rs6979832 genotype BMI	—	therapeutic	Serious
Obesity and metabolic comorbidity in bipolar disorder: do patients on lithium comprise a subgroup? A naturalistic study. Prillo J. et al.. BMC psychiatry 21(1) 558. (2021)	Cross Sectional	Bipolar unspecified	Outpatient	129	—	—	0.00 wk	Mean BMI BMI	-1.10 BMI p 0.895	therapeutic	Serious
The impact of binge eating behavior on lithium- and quetiapine-associated changes in body weight, body mass index, and waist circumference during 6 months of treatment: Findings from the bipolar CHOICE study. Yaramala SR et al.. Journal of affective disorders 266 772-781. (2020)	RCT	Bipolar unspecified	Outpatient	482	—	—	24.0 wk	Body weight (lbs) change from baseline to 24 weeks kg change	—	therapeutic	High
Lithium vs valproate in the maintenance treatment of bipolar I disorder: A post- hoc analysis of a randomized double-blind placebo-controlled trial. Kang MG et al.. The Australian and New Zealand journal of psychiatry 54(3) 298-307. (2020)	RCT	Bipolar I	Outpatient	159	0.80 mmol/L	high	52.0 wk	Weight gain (adverse event)	—	therapeutic	High
Sequential Multiple Assignment Randomized Treatment (SMART) for Bipolar Disorder at Any Phase of Illness and at least Mild Symptom Severity. Gao K. et al.. Psychopharmacology bulletin 50(2) 8-25. (2020)	RCT	Bipolar I \| bipolar II	Outpatient	112	0.61 mmol/L	medium	26.0 wk	Weight gain (adverse event, Randomization 1 phase, lithium vs divalproex)	—	therapeutic	High
Coprescription of mood stabilizers in schizophrenia, dosing, and clinical correlates: An international study. Lim WK et al.. Human psychopharmacology 35(6) 1-7. (2020)	Cross Sectional	Other	In-/outpatient	3,557	—	—	0.00 wk	Weight gain (adverse event, reported as present/absent in patients with vs without adjunctive mood stabilizer)	1.31 [1.00, 1.72] p 0.052	therapeutic	Serious
The association between leptin and adiponectin, and metabolic syndrome components and serum levels of lipid peroxidation in bipolar disorder patients treated with lithium and valproic acid. Dolab N. et al.. Heliyon 6(7) e04553. (2020)	Cross Sectional	Bipolar unspecified	—	87	113 mg~ elem./day	—	13.0 wk	Body Mass Index (BMI) BMI	2.80 BMI p 0.010	therapeutic	Serious
Clinical response and metabolic effects of lithium in 323 mood disorder patients. Pinna M. et al.. Journal of affective disorders 270 9-14. (2020)	Retrospective Cohort	Mixed mood disorder	Outpatient	323	142 mg~ elem./day 0.62 mmol/L	medium	593 wk	Body Mass Index (BMI) before vs during lithium treatment BMI	—	therapeutic	Serious
Aripiprazole Augmentation to Mood Stabilizers for Obsessive-Compulsive Symptoms in Bipolar Disorder. Di Salvo G. et al.. Medicina (Kaunas, Lithuania) 57(1). (2020)	Prospective Cohort	Bipolar unspecified	Outpatient	70	—	—	12.0 wk	Weight gain (adverse event, most common side effects list)	—	therapeutic	Serious
Pre- and postnatal environmental boron exposure and infant growth: Results from a mother-child cohort in northern Argentina. Hjelm C. et al.. Environmental research 171 60-68. (2019)	Prospective Cohort	Healthy volunteers	Community	177	—	—	26.0 wk	Infant body weight in relation to infant urinary boron exposure (paper's primary exposure-outcome analysis; lithium was a covariate, not the exposure of interest, and no lithium-weight effect estimate is reported) kg	—	drinking water	No Information
Leptin gene polymorphisms are associated with weight gain during lithium augmentation in patients with major depression. Bopp SK et al.. European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology 29(2) 211-221. (2019)	Prospective Cohort	Unipolar depression (MDD)	—	185	0.70 mmol/L	medium	30.0 wk	Body mass index (BMI) during lithium augmentation BMI	—	therapeutic	Serious
Psychiatric and physical outcomes of long-term use of lithium in older adults with bipolar disorder and major depressive disorder: A cross-sectional multicenter study. Morlet E. et al.. Journal of affective disorders 259 210-217. (2019)	Cross Sectional	Mixed mood disorder	Outpatient	281	136 mg~ elem./day	—	—	Obesity (BMI > 30 kg/m2)	0.86 [0.35, 2.08] p 0.737	therapeutic	Serious
Cytokine serum levels remain unchanged during lithium augmentation of antidepressants in major depression. Ricken R. et al.. Journal of psychiatric research 96 203-208. (2018)	Prospective Cohort	Unipolar depression (MDD)	—	95	0.71 mmol/L	medium	4.00 wk	Body mass index (BMI) BMI	—	therapeutic	Serious
Reasons for lithium discontinuation in men and women with bipolar disorder: a retrospective cohort study. Öhlund L. et al.. BMC psychiatry 18(1) 37. (2018)	Retrospective Cohort	Other	—	468	—	—	—	Lithium discontinuation due to weight gain (adverse effect leading to stopping lithium)	—	therapeutic	Moderate
Lithium treatment in bipolar adolescents: a follow-up naturalistic study. Masi G. et al.. Neuropsychiatric disease and treatment 14 2749-2753. (2018)	Retrospective Cohort	Bipolar unspecified	In-/outpatient	30	161 mg elem./day 0.70 mmol/L	medium	34.8 wk	Body mass index (BMI) BMI	—	therapeutic	Serious
Increased Prevalence of Obesity/Type 2 Diabetes and Lower Levels of Lithium in Rural Texas Counties May Explain Greater Alzheimer's Disease Risk. Baranowski BJ et al.. Journal of Alzheimer's disease : JAD 64(1) 303-308. (2018)	Cross Sectional	Other	—	155	—	—	—	Prevalence of obesity (BMI >30 kg/m2)	1.10 p —	drinking water	Critical
Melatonin for Reducing Weight Gain Following Administration of Atypical Antipsychotic Olanzapine for Adolescents with Bipolar Disorder: A Randomized, Double-Blind, Placebo-Controlled Trial. Mostafavi SA et al.. Journal of child and adolescent psychopharmacology 27(5) 440-444. (2017)	RCT	Bipolar I	Outpatient	48	—	—	12.0 wk	Body weight increase (mean rise in body weight, kg) kg change	-2.40 kg change p 0.065 †	therapeutic	Some Concerns
Ghrelin Serum Concentrations Are Associated with Treatment Response During Lithium Augmentation of Antidepressants. Ricken R. et al.. The international journal of neuropsychopharmacology 20(9) 692-697. (2017)	Prospective Cohort	Unipolar depression (MDD)	In-/outpatient	85	0.71 mmol/L	medium	4.00 wk	Body mass index (BMI) BMI	—	therapeutic	Serious
Long-term lithium treatment in bipolar disorder: effects on glomerular filtration rate and other metabolic parameters. Tondo L. et al.. International journal of bipolar disorders 5(1) 27. (2017)	Retrospective Cohort	Bipolar unspecified	Outpatient	312	156 mg elem./day 0.66 mmol/L	medium	936 wk	Body-mass index (BMI) BMI	—	therapeutic	Serious
A Prospective Study of Adverse Drug Reactions in Patients with Bipolar Disorder in Psychiatry Outpatient Department of a Tertiary Care Hospital. Shah A. et al.. Journal of clinical and diagnostic research : JCDR 11(5) FC24-FC28. (2017)	Prospective Cohort	Bipolar unspecified	Outpatient	180	—	—	65.0 wk	Weight gain (adverse drug reaction, whole cohort, drugs implicated including lithium) % gaining ≥7%	—	therapeutic	Serious
Efficacy of Lurasidone in Adults Aged 55 Years and Older With Bipolar Depression: Post Hoc Analysis of 2 Double-Blind, Placebo-Controlled Studies. Sajatovic M. et al.. The Journal of clinical psychiatry 77(10) e1324-e1331. (2016)	RCT	Bipolar I	Outpatient	142	—	—	6.00 wk	Body weight change from baseline (monotherapy study, pooled lurasidone doses) kg change	—	therapeutic	Some Concerns
Lurasidone in the long-term treatment of patients with bipolar disorder: a 24-week open-label extension study. Ketter TA et al.. Depression and anxiety 33(5) 424-34. (2016)	Prospective Cohort	Bipolar I	Outpatient	817	175 mg~ elem./day 0.66 mmol/L	medium	26.0 wk	Mean change in body weight from double-blind baseline to month 6 (observed cases) kg change	—	therapeutic	Serious
Leptin serum concentrations are associated with weight gain during lithium augmentation. Ricken R. et al.. Psychoneuroendocrinology 71 31-5. (2016)	Prospective Cohort	Unipolar depression (MDD)	Inpatient	89	0.71 mmol/L	medium	4.00 wk	Body mass index (BMI) BMI	—	therapeutic	Serious
Adverse Renal, Endocrine, Hepatic, and Metabolic Events during Maintenance Mood Stabilizer Treatment for Bipolar Disorder: A Population-Based Cohort Study. Hayes JF et al.. PLoS medicine 13(8) e1002058. (2016)	Retrospective Cohort	Bipolar unspecified	—	6,671	—	—	77.1 wk	>15% weight gain from baseline % gaining ≥7%	1.62 % gaining ≥7% [1.31, 2.01] p 0.001	therapeutic	Serious
Effects of maintenance lithium treatment on serum parathyroid hormone and calcium levels: a retrospective longitudinal naturalistic study. Albert U. et al.. Neuropsychiatric disease and treatment 11 1785-91. (2015)	Retrospective Cohort	Bipolar unspecified	Outpatient	31	135 mg~ elem./day 0.66 mmol/L	medium	80.9 wk	Body mass index (BMI) BMI	—	therapeutic	Moderate
Importance of early weight changes to predict long-term weight gain during psychotropic drug treatment. Vandenberghe F. et al.. The Journal of clinical psychiatry 76(11) e1417-23. (2015)	Prospective Cohort	Mixed mood disorder	In-/outpatient	351	—	—	52.0 wk	Long-term weight gain ≥20% from baseline at one year, predicted by early weight gain >5% at one month % gaining ≥5%	6.40 % gaining ≥5% p <0.001	therapeutic	Serious
The McGill Geriatric Lithium-Induced Diabetes Insipidus Clinical Study (McGLIDICS). Rej S. et al.. Canadian journal of psychiatry. Revue canadienne de psychiatrie 59(6) 327-34. (2014)	Cross Sectional	Bipolar unspecified	Outpatient	100	122 mg~ elem./day 0.64 mmol/L	medium	0.00 wk	Weight (kg) kg	-8.60 kg p 0.120	therapeutic	Moderate
Lithium treatment in elderly patients affected by mood disorders. Raja M. et al.. Rivista di psichiatria 49(4) 180-2. (2014)	Retrospective Cohort	Mixed mood disorder	—	163	0.32 mmol/L	low	136 wk	>7% increase from baseline body weight % gaining ≥7%	—	therapeutic	Serious
Renal replacement therapy associated with lithium nephrotoxicity in Australia. Roxanas M. et al.. The Medical journal of Australia 200(4) 226-8. (2014)	Retrospective Cohort	Other	Community	38,503	—	—	1096 wk	Median body mass index (kg/m2) at commencement of RRT BMI	—	therapeutic	Serious
Investigation into the long-term metabolic effects of aripiprazole adjunctive to lithium, valproate, or lamotrigine. Kemp DE et al.. Journal of affective disorders 148(1) 84-91. (2013)	RCT	Bipolar I	In-/outpatient	337	—	—	52.0 wk	Mean change in body weight from baseline at Week 52, randomized phase (observed cases) kg change	-0.05 kg change [-2.10, 2.00] p —	therapeutic	Some Concerns
Post-acute effectiveness of lithium in pediatric bipolar I disorder. Findling RL et al.. Journal of child and adolescent psychopharmacology 23(2) 80-90. (2013)	Prospective Cohort	Bipolar I	Outpatient	41	276 mg elem./day 1.00 mmol/L	high	14.9 wk	Body weight (kg) kg change	—	therapeutic	Serious
Ziprasidone with adjunctive mood stabilizer in the maintenance treatment of bipolar I disorder: long-term changes in weight and metabolic profiles. Kemp DE et al.. European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology 22(2) 123-31. (2012)	RCT	Bipolar I	Outpatient	240	—	—	24.0 wk	Body weight change (double-blind Phase 2, mean change from baseline) kg change	—	therapeutic	Some Concerns
Fetal, neonatal and developmental outcomes of lithium-exposed pregnancies. van der Lugt NM et al.. Early human development 88(6) 375-8. (2012)	Retrospective Cohort	Bipolar unspecified	—	15	—	—	—	Body weight (kg) at follow-up assessment kg	—	therapeutic	Serious
Psychotropic drug-induced weight gain and other metabolic complications in a Swiss psychiatric population. Choong E. et al.. Journal of psychiatric research 46(4) 540-8. (2012)	Cross Sectional	Other	Outpatient	196	167 mg elem./day	—	135 wk	Important weight gain (>10% of baseline weight) during current drug treatment % gaining ≥7%	0.17 % gaining ≥7% [0.04, 0.63] p 0.008	therapeutic	Serious
Safety and tolerability of lamotrigine: results from 12 placebo-controlled clinical trials and clinical implications. Seo HJ et al.. Clinical neuropharmacology 34(1) 39-47. (2011)	RCT	Bipolar unspecified	—	—	—	—	76.0 wk	Mean weight change over 76-week maintenance treatment (study 10, flexible-dose lamotrigine) kg change	6.40 kg change p —	therapeutic	Some Concerns
A 52-week, double-blind evaluation of the metabolic effects of aripiprazole and lithium in bipolar I disorder. McIntyre RS et al.. The primary care companion for CNS disorders 13(6). (2011)	RCT	Bipolar I	Inpatient	—	225 mg~ elem./day	—	52.0 wk	Change in body weight from baseline to week 52 kg change	—	therapeutic	Some Concerns
Thyroid function and lipid profile in bipolar I patients. Ezzaher A. et al.. Asian journal of psychiatry 4(2) 139-43. (2011)	Cross Sectional	Bipolar I	—	130	—	—	0.00 wk	Body mass index (BMI) in bipolar I patients vs controls BMI	—	therapeutic	Serious
Effectiveness of olanzapine monotherapy and olanzapine combination treatment in the long term following acute mania--results of a two year observational study in bipolar disorder (EMBLEM). Gonzalez-Pinto A. et al.. Journal of affective disorders 131(1-3) 320-9. (2011)	Prospective Cohort	Bipolar I	Outpatient	1,076	—	—	92.0 wk	Mean weight change during the maintenance phase (12 weeks to 2 years) kg change	1.00 kg change p 0.024	therapeutic	Serious
Lithium in drinking water and thyroid function. Broberg K. et al.. Environmental health perspectives 119(6) 827-30. (2011)	Cross Sectional	Healthy volunteers	Community	202	—	—	0.00 wk	Body mass index (BMI) BMI	0.14 BMI [-0.06, 0.35] p 0.160	drinking water	Moderate
Assessment of safety, tolerability and effectiveness of adjunctive aripiprazole to lithium/valproate in bipolar mania: a 46-week, open-label extension following a 6-week double-blind study. Vieta E. et al.. Current medical research and opinion 26(6) 1485-96. (2010)	RCT	Bipolar I	Outpatient	283	208 mg~ elem./day	—	46.0 wk	Mean weight change from double-blind endpoint to Week 46 (LOCF) kg change	0.30 kg change p —	therapeutic	High
Weight gain, obesity, and metabolic indices following a first manic episode: prospective 12-month data from the Systematic Treatment Optimization Program for Early Mania (STOP-EM). Bond DJ et al.. Journal of affective disorders 124(1-2) 108-17. (2010)	Prospective Cohort	Bipolar I	Outpatient	47	—	—	52.0 wk	Mean weight gain over 12 months (lithium vs divalproex, BMI-adjusted) kg change	—	therapeutic	Serious
Medical comorbidity in bipolar disorder: relationship between illnesses of the endocrine/metabolic system and treatment outcome. Kemp DE et al.. Bipolar disorders 12(4) 404-13. (2010)	Prospective Cohort	Bipolar I	In-/outpatient	225	—	—	24.0 wk	BMI as predictor of depression response/remission to lithium+valproate (logistic regression)	0.93 [0.87, 0.99] p 0.020	therapeutic	Serious
Metabolic, digestive, and reproductive adverse events associated with antimanic treatment in children and adolescents: a retrospective cohort study. Jerrell JM et al.. Primary care companion to the Journal of clinical psychiatry 12(4). (2010)	Retrospective Cohort	Other	—	8,157	—	—	—	Obesity/excessive weight gain (ICD-9 diagnosis codes 278, 278.00, 278.01, 783.1, 783.2)	1.89 [1.64, 2.22] p 0.050	therapeutic	Serious
High prevalence of metabolic disturbances in patients with bipolar disorder in Taiwan. Chang HH et al.. Journal of affective disorders 117(1-2) 124-9. (2009)	Cross Sectional	Bipolar unspecified	Outpatient	117	184 mg~ elem./day 0.67 mmol/L	medium	—	Body mass index (BMI), males BMI	—	therapeutic	Serious
Can body mass index help predict outcome in patients with bipolar disorder? Calkin C. et al.. Bipolar disorders 11(6) 650-6. (2009)	Cross Sectional	Bipolar I	Community	276	—	—	—	Body mass index (BMI) by lithium therapeutic effectiveness BMI	-5.90 BMI p 0.010	therapeutic	Serious
Is valproate promising in cardiac fatal arrhythmias? Comparison of P- and Q-wave dispersion in bipolar affective patients on valproate or lithium-valproate maintenance therapy with healthy controls. Kurt E. et al.. Journal of psychopharmacology (Oxford, England) 23(3) 328-33. (2009)	Cross Sectional	Bipolar unspecified	Outpatient	55	225 mg~ elem./day 0.80 mmol/L	high	—	Body mass index (BMI) BMI	—	therapeutic	Serious
Effectiveness of lithium in children and adolescents with conduct disorder: a retrospective naturalistic study. Masi G. et al.. CNS drugs 23(1) 59-69. (2009)	Retrospective Cohort	Other	In-/outpatient	60	—	—	36.6 wk	Weight gain in patients taking lithium as monotherapy (mean kg) kg change	—	therapeutic	Serious
Hospital use of antipsychotic drugs: polytherapy. Centorrino F. et al.. Comprehensive psychiatry 49(1) 65-9. (2008)	Retrospective Cohort	Other	—	305	—	—	2.23 wk	Final body weight during hospitalization by antipsychotic+mood stabilizer cotreatment vs monotherapy (CPZ-eq dose analysis; weight gain associated with polytherapy)	—	therapeutic	Serious
Weight change in the acute treatment of bipolar I disorder: a naturalistic observational study of psychiatric inpatients. Kim B. et al.. Journal of affective disorders 105(1-3) 45-52. (2008)	Prospective Cohort	Bipolar I	Inpatient	179	—	—	4.00 wk	Change in weight after 4 weeks hospitalization according to medication(s) frequently used kg change	—	therapeutic	Serious
Safety and tolerability of quetiapine in the treatment of acute mania in bipolar disorder. Adler CM et al.. Journal of affective disorders 100 Suppl 1 S15-22. (2007)	RCT	Bipolar I	—	809	0.76 mmol/L	medium	12.0 wk	Mean change in weight from baseline (combination therapy: quetiapine+Li/DVP vs placebo+Li/DVP) kg change	1.70 kg change [1.10, 2.23] p —	therapeutic	Some Concerns
A 6-month randomized open-label comparison of continuation of oral atypical antipsychotic therapy or switch to long acting injectable risperidone in patients with bipolar disorder. Yatham LN et al.. Acta psychiatrica Scandinavica. Supplementum (434) 50-6. (2007)	RCT	Bipolar I	Community	49	—	—	26.0 wk	Weight	—	therapeutic	High
Lithium therapy for unipolar and bipolar depression among the middle-aged and older adult patient subpopulation. Lepkifker E. et al.. Depression and anxiety 24(8) 571-6. (2007)	Retrospective Cohort	Mixed mood disorder	Outpatient	60	—	—	503 wk	Weight gain (adverse effect during lithium treatment)	—	therapeutic	Serious
Effects of lamotrigine and lithium on body weight during maintenance treatment of bipolar I disorder. Sachs G. et al.. Bipolar disorders 8(2) 175-81. (2006)	RCT	Bipolar I	—	583	—	—	76.0 wk	Mean change in weight (kg) from randomization day 1 to week 52 (MMRM, covariate-adjusted) kg change	2.00 kg change [-0.30, 4.40] p 0.094	therapeutic	Some Concerns
Adjunct divalproex or lithium to clozapine in treatment-resistant schizophrenia. Kelly DL et al.. The Psychiatric quarterly 77(1) 81-95. (2006)	Retrospective Cohort	Other	Inpatient	49	—	—	26.0 wk	Weight change (pounds) over 6 months kg change	4.60 kg change p —	therapeutic	Serious
Olanzapine treatment in adolescents with severe conduct disorder. Masi G. et al.. European psychiatry : the journal of the Association of European Psychiatrists 21(1) 51-7. (2006)	Retrospective Cohort	Other	In-/outpatient	23	—	—	38.3 wk	Weight gain at end of follow-up kg change	—	therapeutic	Serious
A one-year open-label trial of risperidone augmentation in lithium nonresponder youth with preschool-onset bipolar disorder. Pavuluri MN et al.. Journal of child and adolescent psychopharmacology 16(3) 336-50. (2006)	Prospective Cohort	Bipolar unspecified	Outpatient	38	150 mg~ elem./day 0.90 mmol/L	high	52.0 wk	Body weight (baseline to end of study) kg	—	therapeutic	Serious
Atypical antipsychotic usage-related higher serum leptin levels and disabled lipid profiles in euthymic bipolar patients. Gergerlioglu HS et al.. Neuropsychobiology 53(2) 108-12. (2006)	Cross Sectional	Bipolar I	Outpatient	106	215 mg~ elem./day	—	—	Body mass index (BMI) in mood stabilizer (MS) user patients vs controls BMI	—	therapeutic	Serious
Plasma levels of leptin and endogenous immune modulators during treatment with carbamazepine or lithium. Himmerich H. et al.. Psychopharmacology 179(2) 447-51. (2005)	Prospective Cohort	Mixed mood disorder	Inpatient	25	—	—	4.00 wk	Body mass index (BMI) BMI	—	therapeutic	Moderate
Longitudinal evaluation of reproductive function in women treated for bipolar disorder. Rasgon NL et al.. Journal of affective disorders 89(1-3) 217-25. (2005)	Prospective Cohort	Bipolar unspecified	Outpatient	25	—	—	104 wk	Self-reported weight gain over the prior 6 months to enrollment	—	therapeutic	Serious
Reproductive function and risk for PCOS in women treated for bipolar disorder. Rasgon NL et al.. Bipolar disorders 7(3) 246-59. (2005)	Cross Sectional	Bipolar unspecified	Outpatient	80	—	—	—	Total weight gain since treatment (lbs), by medication group (No divalproex group, which includes lithium-treated patients) kg change	—	therapeutic	Serious
Safety and tolerability of lamotrigine for bipolar disorder. Bowden CL et al.. Drug safety 27(3) 173-84. (2004)	RCT	Bipolar I	Outpatient	1,792	166 mg~ elem./day	—	76.0 wk	Weight gain reported as adverse event across eight controlled trials	—	therapeutic	Some Concerns
Long-term observational comparison of risperidone and olanzapine in bipolar disorder. Ghaemi SN et al.. Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists 16(2) 69-73. (2004)	Retrospective Cohort	Bipolar unspecified	Outpatient	29	—	—	65.9 wk	Weight gain (>5 lbs, clinically attributed to neuroleptic)	4.29 [1.09, 16.8] p —	therapeutic	Serious
Adjunctive quetiapine in bipolar patients partially responsive to lithium or valproate. Sokolski KN et al.. Progress in neuro-psychopharmacology & biological psychiatry 27(5) 863-6. (2003)	Retrospective Cohort	Bipolar I	Outpatient	16	0.91 mmol/L	high	—	Weight gain (adverse event, adjunctive quetiapine)	—	therapeutic	Critical
Valproate, bipolar disorder and polycystic ovarian syndrome. McIntyre RS et al.. Bipolar disorders 5(1) 28-35. (2003)	Cross Sectional	Bipolar unspecified	Outpatient	38	183 mg~ elem./day 0.92 mmol/L	high	—	Body weight (kg) kg	1.40 kg p 0.820	therapeutic	Serious
Risperidone in acute and continuation treatment of mania. Yatham LN et al.. International clinical psychopharmacology 18(4) 227-35. (2003)	Prospective Cohort	Bipolar I	Community	108	0.72 mmol/L	medium	12.0 wk	Weight gain over 12-week study (mean change in body weight) kg change	—	therapeutic	Critical
Obesity as a correlate of outcome in patients with bipolar I disorder. Fagiolini A. et al.. The American journal of psychiatry 160(1) 112-7. (2003)	Prospective Cohort	Bipolar I	In-/outpatient	175	0.81 mmol/L	high	—	Obesity (BMI >= 30.00 kg/m2) prevalence and its association with clinical outcomes	—	therapeutic	Serious
Triglyceride, cholesterol and weight changes among risperidone-treated youths. A retrospective study. Martin A. et al.. European child & adolescent psychiatry 11(3) 129-33. (2002)	Retrospective Cohort	Other	Inpatient	22	—	—	21.3 wk	Weight change (kg) among risperidone-treated youths kg change	—	therapeutic	Serious
Changes in body weight and body mass index among psychiatric patients receiving lithium, valproate, or topiramate: an open-label, nonrandomized chart review. Chengappa KN et al.. Clinical therapeutics 24(10) 1576-84. (2002)	Retrospective Cohort	Other	—	214	178 mg elem./day	—	12.7 wk	Change in body weight kg change	7.50 kg change p —	therapeutic	Serious
Thyroid abnormalities in lithium-treated patients with bipolar affective disorder. Cayköylü A. et al.. The Journal of international medical research 30(1) 80-4. (2002)	Cross Sectional	Bipolar I	—	42	169 mg~ elem./day	—	—	Weight gain (>10% increase in body weight) among patients with increased T4-to-T3 conversion	—	therapeutic	Serious
Endocrine effects of lithium carbonate in healthy premenopausal women: relationship with body weight regulation. Baptista T. et al.. Progress in neuro-psychopharmacology & biological psychiatry 24(1) 1-16. (2000)	RCT	Healthy volunteers	—	23	169 mg elem./day 0.31 mmol/L	low	4.00 wk	Body weight change during treatment kg change	-0.14 kg change p 0.890 †	therapeutic	Some Concerns
An open longitudinal study of patients with bipolar rapid cycling treated with lithium or lamotrigine for mood stabilization. Walden J. et al.. Bipolar disorders 2(4) 336-9. (2000)	RCT	Bipolar I	In-/outpatient	14	0.78 mmol/L	medium	52.0 wk	Weight gain (adverse event, not leading to discontinuation)	—	therapeutic	Serious
Non-adherence with long-term prophylaxis: a 6-year naturalistic follow-up study of affectively ill patients. Schumann C. et al.. Psychiatry research 89(3) 247-57. (1999)	Prospective Cohort	Mixed mood disorder	Outpatient	76	—	—	312 wk	Weight gain (side effect reported during 6-year follow-up)	—	therapeutic	Serious
Lack of advantage for imipramine combined with lithium versus imipramine alone in the treatment of major depression--a double-blind controlled study. Shahal B. et al.. Biological psychiatry 40(11) 1181-3. (1996)	RCT	Unipolar depression (MDD)	Inpatient	22	0.80 mmol/L	high	5.00 wk	Body weight kg	—	therapeutic	Some Concerns
A Retrospective Chart Review of Lithium Side Effects in a Geriatric Outpatient Population. Holroyd S. et al.. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry 2(4) 346-351. (1994)	Retrospective Cohort	Mixed mood disorder	Outpatient	114	0.50 mmol/L	low	390 wk	Weight gain (side effect)	—	therapeutic	Serious
Predictors of response to lithium and triiodothyronine augmentation of antidepressants in tricyclic non-responders. Joffe RT et al.. The British journal of psychiatry : the journal of mental science 163 574-8. (1993)	RCT	Unipolar depression (MDD)	Outpatient	34	0.68 mmol/L	medium	2.00 wk	Hamilton Rating Scale for Depression (HRSD) weight loss factor score — used here as the paper's primary quantitative symptom measure relevant to weight; no continuous body-weight-in-kg outcome was reported in this paper	—	therapeutic	Some Concerns
Side effects of chronic lithium therapy in Hong Kong Chinese: an ethnopsychiatric perspective. Lee S.. Culture, medicine and psychiatry 17(3) 301-20. (1993)	Cross Sectional	Mixed mood disorder	Outpatient	70	208 mg elem./day 0.63 mmol/L	medium	140 wk	Body Mass Index BMI	1.00 BMI p —	therapeutic	Serious
Carbamazepine versus lithium in the prophylaxis of bipolar affective disorder. Coxhead N. et al.. Acta psychiatrica Scandinavica 85(2) 114-8. (1992)	RCT	Bipolar unspecified	—	—	—	—	—	Weight change (tendency to gain/lose weight) kg change	—	therapeutic	High
On the pathogenesis of abnormal involuntary movements in lithium-treated patients with major affective disorder. Axelsson R. et al.. European archives of psychiatry and clinical neuroscience 241(1) 1-7. (1991)	Prospective Cohort	Mixed mood disorder	Outpatient	37	142 mg elem./day 0.56 mmol/L	low	801 wk	Body weight kg	—	therapeutic	Serious
The efficacy of low-dose lithium: clinical, psychological and biological correlates. Abou-Saleh MT et al.. Journal of psychiatric research 23(2) 157-62. (1989)	RCT	Mixed mood disorder	Outpatient	90	134 mg elem./day 0.69 mmol/L	medium	52.0 wk	Change in weight during trial kg change	—	therapeutic	Some Concerns
Long-term catamnesis on the topic of uses and side effects of lithium prevention of phasic psychoses Koufen H. et al.. Fortschritte der Neurologie-Psychiatrie 57(9) 374-82. (1989)	Retrospective Cohort	Mixed mood disorder	Community	124	154 mg elem./day 0.63 mmol/L	medium	676 wk	Gewichtszunahme (weight gain), reported as an adverse effect at long-term follow-up % gaining ≥7%	—	therapeutic	Serious
Factors associated with discontinuation of long-term lithium treatment. Nilsson A. et al.. Acta psychiatrica Scandinavica 80(3) 221-30. (1989)	Prospective Cohort	Other	Outpatient	64	194 mg elem./day 0.63 mmol/L	medium	364 wk	Weight gain (side effect frequency, rated by psychiatrist at 1980 investigation)	—	therapeutic	Serious
Lithium-induced changes in the body mass index. Mathew B. et al.. Acta psychiatrica Scandinavica 80(6) 538-40. (1989)	Retrospective Cohort	Mixed mood disorder	Outpatient	117	129 mg~ elem./day 0.54 mmol/L	low	244 wk	Body mass index (BMI) BMI	—	therapeutic	Serious
Prospective studies on a lithium cohort. 3. Tremor, weight gain, diarrhea, psychological complaints. Vestergaard P. et al.. Acta psychiatrica Scandinavica 78(4) 434-41. (1988)	Prospective Cohort	Mixed mood disorder	Outpatient	—	161 mg elem./day 0.68 mmol/L	medium	364 wk	Body weight change during lithium treatment kg change	—	therapeutic	Serious
Lithium, polyuria and abnormal diurnal weight gain in psychosis. Vieweg WV et al.. Acta psychiatrica Scandinavica 78(4) 510-4. (1988)	Cross Sectional	Other	—	73	0.90 mmol/L	high	3.00 wk	Body weight (7 a.m. and 4 p.m., used to derive normalized diurnal weight gain) kg	1.60 kg p —	therapeutic	Serious

Response and Adverse Effects to Lithium Treatment in Patients With Bipolar Disorder at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia.

Hailu AE et al.. BioMed research international 2026(1) e8884457. (2026)

Retrospective CohortBipolar unspecifiedIn-/outpatientN = 26226.0 wkRoB: Serious

Outcome: Weight gain (patient-reported adverse effect) (% gaining ≥7%)

Dose: —

Weight: —

Effect of psychopharmacological combinations on psychopathological symptom burden and BMI trajectories in patients with eating disorders.

Panarello E. et al.. Frontiers in psychiatry 17 1750187. (2026)

Prospective CohortOtherInpatientN = 12710.0 wkRoB: Serious

anorexia tx

Outcome: Change in Body Mass Index (DBMI) over ten-week inpatient treatment (BMI change)

Dose: —

Weight:

-1.70 BMI change

[-3.17, -0.23]

p 0.023

Demographic and Clinical Correlates of Body Mass Index in Older Age Bipolar Disorder: Results from the GAGE-BD Project.

Chan CK et al.. Medicina (Kaunas, Lithuania) 62(4). (2026)

Cross SectionalBipolar unspecifiedOutpatientN = 1,226RoB: Serious

Outcome: Body mass index (BMI, kg/m2) associated with lithium use (BMI)

Dose: —

Weight:

-0.37 BMI

[-0.63, -0.12]

p 0.005

A Survey Exploring People's Experiences With Lithium Bought as a Supplement: Une enquête sur l'expérience des personnes avec le lithium en supplément.

Strawbridge R. et al.. Canadian journal of psychiatry. Revue canadienne de psychiatrie 70(10) 782-795. (2025)

Cross SectionalOtherCommunityN = 21119.3 wkRoB: Critical

supplement

Outcome: Weight side effect / weight change reported by lithium supplement users

Dose: —

Weight: —

Efficacy and Safety of Adjunctive Aripiprazole LAI or Paliperidone LAI for the Management of Patients Suffering from Bipolar I Disorder with Comorbid Obsessive-Compulsive Disorder.

Martiadis V. et al.. Journal of clinical medicine 14(3). (2025)

Retrospective CohortBipolar ICommunityN = 2724.0 wkRoB: Serious

Outcome: Body weight (BW) change, PP-LAI vs ARI-LAI groups (mood stabilizer subgroup includes lithium and valproate patients combined; lithium not separately reported for this outcome) (kg change)

Dose: —

Weight: —

Psychotropic drug-induced adverse drug reactions in 462,661 psychiatric inpatients in relation to age: results from a German drug surveillance program from 1993-2016.

Seifert J. et al.. Annals of general psychiatry 23(1) 47. (2024)

Retrospective CohortOtherInpatientN = 462,661RoB: Serious

Outcome: Changes in body weight (weight gain) as an adverse drug reaction, ≥65 vs <65 years, all psychotropic drugs combined

Dose:

127 mg elem./day

Weight:

0.07

[0.04, 0.14]

p —

Predicting maintenance lithium response for bipolar disorder from electronic health records-a retrospective study.

Hayes JF et al.. PeerJ 12 e17841. (2024)

Retrospective CohortBipolar unspecifiedN = 31,518104 wkRoB: Serious

Outcome: Overweight or obese status (baseline characteristic, not a treatment-emergent weight outcome)

Dose: —

Weight: —

Mega-analysis of association between obesity and cortical morphology in bipolar disorders: ENIGMA study in 2832 participants.

McWhinney SR et al.. Psychological medicine 53(14) 6743-6753. (2023)

Cross SectionalBipolar unspecifiedOutpatientN = 2,832RoB: Serious

Outcome: Body mass index (BMI) association with current lithium treatment (all BD participants) (BMI)

Dose: —

Weight: —

The Role of Mood Stabilizers in Children and Adolescents with Anorexia Nervosa: A 1-year Follow-Up, Propensity Score-Matched Study.

Pruccoli J. et al.. Pharmacopsychiatry 56(3) 118-125. (2023)

Retrospective CohortOtherN = 23418.0 wkRoB: Serious

Outcome: BMI change (admission to discharge) (BMI change)

Dose: —

Weight: —

Preliminary results from the Australian Genetics of Bipolar Disorder Study: A nation-wide cohort.

Lind PA et al.. The Australian and New Zealand journal of psychiatry 57(11) 1428-1442. (2023)

Cross SectionalBipolar unspecifiedN = 6,682RoB: Critical

Outcome: Weight gain reported as an adverse drug reaction (ever experienced, lithium users)

Dose: —

Weight: —

Lithium Pharmacokinetics in the Perinatal Patient With Bipolar Disorder.

Clark CT et al.. Journal of clinical pharmacology 62(11) 1385-1392. (2022)

Prospective CohortBipolar IOutpatientN = 4RoB: Serious

low

Outcome: Body mass index (BMI) change from baseline to end of pregnancy (BMI change)

Dose:

155 mg~ elem./day

0.53 mmol/L

Weight: —

Dose-dependent transcriptional effects of lithium and adverse effect burden in a psychiatric cohort.

Krull F. et al.. Progress in neuro-psychopharmacology & biological psychiatry 112 110408. (2022)

Cross SectionalOtherIn-/outpatientN = 1,450RoB: Serious

Outcome: Weight gain (UKU adverse effect item) association with lithium-associated gene expression (LAMTOR1/LAMTOR4)

Dose: —

Weight: —

Lithium use during breastfeeding was safe in healthy full-term infants under strict monitoring.

Heinonen E. et al.. Acta paediatrica (Oslo, Norway : 1992) 111(10) 1891-1898. (2022)

Retrospective CohortBipolar unspecifiedOutpatientN = 30RoB: Serious

mediumlow-dose clinical

Outcome: Inadequate infant growth (<15 g/day weight gain since last visit) (% gaining ≥7%)

Dose:

22.5 mg elem./day

0.60 mmol/L

Weight: —

Differences between bipolar disorder types 1 and 2 support the DSM two-syndrome concept.

Tondo L. et al.. International journal of bipolar disorders 10(1) 21. (2022)

Cross SectionalBipolar unspecifiedOutpatientN = 1,377RoB: Serious

low

Outcome: Body-mass index (BMI) and obesity prevalence, BD-1 vs BD-2 (whole-cohort diagnostic comparison, not restricted to lithium users) (BMI)

Dose:

135 mg~ elem./day

0.58 mmol/L

Weight:

0.70 BMI

p 0.040 †

Exploring the Effects of Greek Yogurt Supplementation and Exercise Training on Serum Lithium and Its Relationship With Musculoskeletal Outcomes in Men.

Baranowski RW et al.. Frontiers in nutrition 8 798036. (2021)

RCTHealthy volunteersN = 3012.0 wkRoB: High

drinking water

Outcome: Body mass (kg) (kg)

Dose: —

Weight:

0.40 kg

p 0.930 †

Tolerability of lithium: A naturalistic discontinuation study in older inpatients (≥60 years).

Flapper M. et al.. International journal of geriatric psychiatry 36(8) 1231-1240. (2021)

Retrospective CohortMixed mood disorderOutpatientN = 13578.0 wkRoB: Serious

Outcome: Weight gain as reason for lithium discontinuation

Dose: —

Weight: —

A GWAS top hit for circulating leptin is associated with weight gain but not with leptin protein levels in lithium-augmented patients with major depression.

Bopp SK et al.. European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology 53 114-119. (2021)

Prospective CohortUnipolar depression (MDD)N = 18030.0 wkRoB: Serious

Outcome: BMI (kg/m2) during lithium augmentation, modeled by rs6979832 genotype (BMI)

Dose: —

Weight: —

Obesity and metabolic comorbidity in bipolar disorder: do patients on lithium comprise a subgroup? A naturalistic study.

Prillo J. et al.. BMC psychiatry 21(1) 558. (2021)

Cross SectionalBipolar unspecifiedOutpatientN = 1290.00 wkRoB: Serious

Outcome: Mean BMI (BMI)

Dose: —

Weight:

-1.10 BMI

p 0.895

The impact of binge eating behavior on lithium- and quetiapine-associated changes in body weight, body mass index, and waist circumference during 6 months of treatment: Findings from the bipolar CHOICE study.

Yaramala SR et al.. Journal of affective disorders 266 772-781. (2020)

RCTBipolar unspecifiedOutpatientN = 48224.0 wkRoB: High

Outcome: Body weight (lbs) change from baseline to 24 weeks (kg change)

Dose: —

Weight: —

Lithium vs valproate in the maintenance treatment of bipolar I disorder: A post- hoc analysis of a randomized double-blind placebo-controlled trial.

Kang MG et al.. The Australian and New Zealand journal of psychiatry 54(3) 298-307. (2020)

RCTBipolar IOutpatientN = 15952.0 wkRoB: High

high

Outcome: Weight gain (adverse event)

Dose:

0.80 mmol/L

Weight: —

Sequential Multiple Assignment Randomized Treatment (SMART) for Bipolar Disorder at Any Phase of Illness and at least Mild Symptom Severity.

Gao K. et al.. Psychopharmacology bulletin 50(2) 8-25. (2020)

RCTBipolar I | bipolar IIOutpatientN = 11226.0 wkRoB: High

medium

Outcome: Weight gain (adverse event, Randomization 1 phase, lithium vs divalproex)

Dose:

0.61 mmol/L

Weight: —

Coprescription of mood stabilizers in schizophrenia, dosing, and clinical correlates: An international study.

Lim WK et al.. Human psychopharmacology 35(6) 1-7. (2020)

Cross SectionalOtherIn-/outpatientN = 3,5570.00 wkRoB: Serious

Outcome: Weight gain (adverse event, reported as present/absent in patients with vs without adjunctive mood stabilizer)

Dose: —

Weight:

1.31

[1.00, 1.72]

p 0.052

The association between leptin and adiponectin, and metabolic syndrome components and serum levels of lipid peroxidation in bipolar disorder patients treated with lithium and valproic acid.

Dolab N. et al.. Heliyon 6(7) e04553. (2020)

Cross SectionalBipolar unspecifiedN = 8713.0 wkRoB: Serious

Outcome: Body Mass Index (BMI) (BMI)

Dose:

113 mg~ elem./day

Weight:

2.80 BMI

p 0.010

Clinical response and metabolic effects of lithium in 323 mood disorder patients.

Pinna M. et al.. Journal of affective disorders 270 9-14. (2020)

Retrospective CohortMixed mood disorderOutpatientN = 323593 wkRoB: Serious

medium

Outcome: Body Mass Index (BMI) before vs during lithium treatment (BMI)

Dose:

142 mg~ elem./day

0.62 mmol/L

Weight: —

Aripiprazole Augmentation to Mood Stabilizers for Obsessive-Compulsive Symptoms in Bipolar Disorder.

Di Salvo G. et al.. Medicina (Kaunas, Lithuania) 57(1). (2020)

Prospective CohortBipolar unspecifiedOutpatientN = 7012.0 wkRoB: Serious

Outcome: Weight gain (adverse event, most common side effects list)

Dose: —

Weight: —

Pre- and postnatal environmental boron exposure and infant growth: Results from a mother-child cohort in northern Argentina.

Hjelm C. et al.. Environmental research 171 60-68. (2019)

Prospective CohortHealthy volunteersCommunityN = 17726.0 wkRoB: No Information

drinking water

Outcome: Infant body weight in relation to infant urinary boron exposure (paper's primary exposure-outcome analysis; lithium was a covariate, not the exposure of interest, and no lithium-weight effect estimate is reported) (kg)

Dose: —

Weight: —

Leptin gene polymorphisms are associated with weight gain during lithium augmentation in patients with major depression.

Bopp SK et al.. European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology 29(2) 211-221. (2019)

Prospective CohortUnipolar depression (MDD)N = 18530.0 wkRoB: Serious

medium

Outcome: Body mass index (BMI) during lithium augmentation (BMI)

Dose:

0.70 mmol/L

Weight: —

Psychiatric and physical outcomes of long-term use of lithium in older adults with bipolar disorder and major depressive disorder: A cross-sectional multicenter study.

Morlet E. et al.. Journal of affective disorders 259 210-217. (2019)

Cross SectionalMixed mood disorderOutpatientN = 281RoB: Serious

Outcome: Obesity (BMI > 30 kg/m2)

Dose:

136 mg~ elem./day

Weight:

0.86

[0.35, 2.08]

p 0.737

Cytokine serum levels remain unchanged during lithium augmentation of antidepressants in major depression.

Ricken R. et al.. Journal of psychiatric research 96 203-208. (2018)

Prospective CohortUnipolar depression (MDD)N = 954.00 wkRoB: Serious

medium

Outcome: Body mass index (BMI) (BMI)

Dose:

0.71 mmol/L

Weight: —

Reasons for lithium discontinuation in men and women with bipolar disorder: a retrospective cohort study.

Öhlund L. et al.. BMC psychiatry 18(1) 37. (2018)

Retrospective CohortOtherN = 468RoB: Moderate

Outcome: Lithium discontinuation due to weight gain (adverse effect leading to stopping lithium)

Dose: —

Weight: —

Lithium treatment in bipolar adolescents: a follow-up naturalistic study.

Masi G. et al.. Neuropsychiatric disease and treatment 14 2749-2753. (2018)

Retrospective CohortBipolar unspecifiedIn-/outpatientN = 3034.8 wkRoB: Serious

medium

Outcome: Body mass index (BMI) (BMI)

Dose:

161 mg elem./day

0.70 mmol/L

Weight: —

Increased Prevalence of Obesity/Type 2 Diabetes and Lower Levels of Lithium in Rural Texas Counties May Explain Greater Alzheimer's Disease Risk.

Baranowski BJ et al.. Journal of Alzheimer's disease : JAD 64(1) 303-308. (2018)

Cross SectionalOtherN = 155RoB: Critical

drinking water

Outcome: Prevalence of obesity (BMI >30 kg/m2)

Dose: —

Weight:

1.10

p —

Melatonin for Reducing Weight Gain Following Administration of Atypical Antipsychotic Olanzapine for Adolescents with Bipolar Disorder: A Randomized, Double-Blind, Placebo-Controlled Trial.

Mostafavi SA et al.. Journal of child and adolescent psychopharmacology 27(5) 440-444. (2017)

RCTBipolar IOutpatientN = 4812.0 wkRoB: Some Concerns

Outcome: Body weight increase (mean rise in body weight, kg) (kg change)

Dose: —

Weight:

-2.40 kg change

p 0.065 †

Ghrelin Serum Concentrations Are Associated with Treatment Response During Lithium Augmentation of Antidepressants.

Ricken R. et al.. The international journal of neuropsychopharmacology 20(9) 692-697. (2017)

Prospective CohortUnipolar depression (MDD)In-/outpatientN = 854.00 wkRoB: Serious

medium

Outcome: Body mass index (BMI) (BMI)

Dose:

0.71 mmol/L

Weight: —

Long-term lithium treatment in bipolar disorder: effects on glomerular filtration rate and other metabolic parameters.

Tondo L. et al.. International journal of bipolar disorders 5(1) 27. (2017)

Retrospective CohortBipolar unspecifiedOutpatientN = 312936 wkRoB: Serious

medium

Outcome: Body-mass index (BMI) (BMI)

Dose:

156 mg elem./day

0.66 mmol/L

Weight: —

A Prospective Study of Adverse Drug Reactions in Patients with Bipolar Disorder in Psychiatry Outpatient Department of a Tertiary Care Hospital.

Shah A. et al.. Journal of clinical and diagnostic research : JCDR 11(5) FC24-FC28. (2017)

Prospective CohortBipolar unspecifiedOutpatientN = 18065.0 wkRoB: Serious

Outcome: Weight gain (adverse drug reaction, whole cohort, drugs implicated including lithium) (% gaining ≥7%)

Dose: —

Weight: —

Efficacy of Lurasidone in Adults Aged 55 Years and Older With Bipolar Depression: Post Hoc Analysis of 2 Double-Blind, Placebo-Controlled Studies.

Sajatovic M. et al.. The Journal of clinical psychiatry 77(10) e1324-e1331. (2016)

RCTBipolar IOutpatientN = 1426.00 wkRoB: Some Concerns

Outcome: Body weight change from baseline (monotherapy study, pooled lurasidone doses) (kg change)

Dose: —

Weight: —

Lurasidone in the long-term treatment of patients with bipolar disorder: a 24-week open-label extension study.

Ketter TA et al.. Depression and anxiety 33(5) 424-34. (2016)

Prospective CohortBipolar IOutpatientN = 81726.0 wkRoB: Serious

medium

Outcome: Mean change in body weight from double-blind baseline to month 6 (observed cases) (kg change)

Dose:

175 mg~ elem./day

0.66 mmol/L

Weight: —

Leptin serum concentrations are associated with weight gain during lithium augmentation.

Ricken R. et al.. Psychoneuroendocrinology 71 31-5. (2016)

Prospective CohortUnipolar depression (MDD)InpatientN = 894.00 wkRoB: Serious

medium

Outcome: Body mass index (BMI) (BMI)

Dose:

0.71 mmol/L

Weight: —

Adverse Renal, Endocrine, Hepatic, and Metabolic Events during Maintenance Mood Stabilizer Treatment for Bipolar Disorder: A Population-Based Cohort Study.

Hayes JF et al.. PLoS medicine 13(8) e1002058. (2016)

Retrospective CohortBipolar unspecifiedN = 6,67177.1 wkRoB: Serious

Outcome: >15% weight gain from baseline (% gaining ≥7%)

Dose: —

Weight:

1.62 % gaining ≥7%

[1.31, 2.01]

p 0.001

Effects of maintenance lithium treatment on serum parathyroid hormone and calcium levels: a retrospective longitudinal naturalistic study.

Albert U. et al.. Neuropsychiatric disease and treatment 11 1785-91. (2015)

Retrospective CohortBipolar unspecifiedOutpatientN = 3180.9 wkRoB: Moderate

medium

Outcome: Body mass index (BMI) (BMI)

Dose:

135 mg~ elem./day

0.66 mmol/L

Weight: —

Importance of early weight changes to predict long-term weight gain during psychotropic drug treatment.

Vandenberghe F. et al.. The Journal of clinical psychiatry 76(11) e1417-23. (2015)

Prospective CohortMixed mood disorderIn-/outpatientN = 35152.0 wkRoB: Serious

Outcome: Long-term weight gain ≥20% from baseline at one year, predicted by early weight gain >5% at one month (% gaining ≥5%)

Dose: —

Weight:

6.40 % gaining ≥5%

p <0.001

The McGill Geriatric Lithium-Induced Diabetes Insipidus Clinical Study (McGLIDICS).

Rej S. et al.. Canadian journal of psychiatry. Revue canadienne de psychiatrie 59(6) 327-34. (2014)

Cross SectionalBipolar unspecifiedOutpatientN = 1000.00 wkRoB: Moderate

medium

Outcome: Weight (kg) (kg)

Dose:

122 mg~ elem./day

0.64 mmol/L

Weight:

-8.60 kg

p 0.120

Lithium treatment in elderly patients affected by mood disorders.

Raja M. et al.. Rivista di psichiatria 49(4) 180-2. (2014)

Retrospective CohortMixed mood disorderN = 163136 wkRoB: Serious

low

Outcome: >7% increase from baseline body weight (% gaining ≥7%)

Dose:

0.32 mmol/L

Weight: —

Renal replacement therapy associated with lithium nephrotoxicity in Australia.

Roxanas M. et al.. The Medical journal of Australia 200(4) 226-8. (2014)

Retrospective CohortOtherCommunityN = 38,5031096 wkRoB: Serious

Outcome: Median body mass index (kg/m2) at commencement of RRT (BMI)

Dose: —

Weight: —

Investigation into the long-term metabolic effects of aripiprazole adjunctive to lithium, valproate, or lamotrigine.

Kemp DE et al.. Journal of affective disorders 148(1) 84-91. (2013)

RCTBipolar IIn-/outpatientN = 33752.0 wkRoB: Some Concerns

Outcome: Mean change in body weight from baseline at Week 52, randomized phase (observed cases) (kg change)

Dose: —

Weight:

-0.05 kg change

[-2.10, 2.00]

p —

Post-acute effectiveness of lithium in pediatric bipolar I disorder.

Findling RL et al.. Journal of child and adolescent psychopharmacology 23(2) 80-90. (2013)

Prospective CohortBipolar IOutpatientN = 4114.9 wkRoB: Serious

high

Outcome: Body weight (kg) (kg change)

Dose:

276 mg elem./day

1.00 mmol/L

Weight: —

Ziprasidone with adjunctive mood stabilizer in the maintenance treatment of bipolar I disorder: long-term changes in weight and metabolic profiles.

Kemp DE et al.. European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology 22(2) 123-31. (2012)

RCTBipolar IOutpatientN = 24024.0 wkRoB: Some Concerns

Outcome: Body weight change (double-blind Phase 2, mean change from baseline) (kg change)

Dose: —

Weight: —

Fetal, neonatal and developmental outcomes of lithium-exposed pregnancies.

van der Lugt NM et al.. Early human development 88(6) 375-8. (2012)

Retrospective CohortBipolar unspecifiedN = 15RoB: Serious

Outcome: Body weight (kg) at follow-up assessment (kg)

Dose: —

Weight: —

Psychotropic drug-induced weight gain and other metabolic complications in a Swiss psychiatric population.

Choong E. et al.. Journal of psychiatric research 46(4) 540-8. (2012)

Cross SectionalOtherOutpatientN = 196135 wkRoB: Serious

Outcome: Important weight gain (>10% of baseline weight) during current drug treatment (% gaining ≥7%)

Dose:

167 mg elem./day

Weight:

0.17 % gaining ≥7%

[0.04, 0.63]

p 0.008

Safety and tolerability of lamotrigine: results from 12 placebo-controlled clinical trials and clinical implications.

Seo HJ et al.. Clinical neuropharmacology 34(1) 39-47. (2011)

RCTBipolar unspecified76.0 wkRoB: Some Concerns

Outcome: Mean weight change over 76-week maintenance treatment (study 10, flexible-dose lamotrigine) (kg change)

Dose: —

Weight:

6.40 kg change

p —

A 52-week, double-blind evaluation of the metabolic effects of aripiprazole and lithium in bipolar I disorder.

McIntyre RS et al.. The primary care companion for CNS disorders 13(6). (2011)

RCTBipolar IInpatient52.0 wkRoB: Some Concerns

Outcome: Change in body weight from baseline to week 52 (kg change)

Dose:

225 mg~ elem./day

Weight: —

Thyroid function and lipid profile in bipolar I patients.

Ezzaher A. et al.. Asian journal of psychiatry 4(2) 139-43. (2011)

Cross SectionalBipolar IN = 1300.00 wkRoB: Serious

Outcome: Body mass index (BMI) in bipolar I patients vs controls (BMI)

Dose: —

Weight: —

Effectiveness of olanzapine monotherapy and olanzapine combination treatment in the long term following acute mania--results of a two year observational study in bipolar disorder (EMBLEM).

Gonzalez-Pinto A. et al.. Journal of affective disorders 131(1-3) 320-9. (2011)

Prospective CohortBipolar IOutpatientN = 1,07692.0 wkRoB: Serious

Outcome: Mean weight change during the maintenance phase (12 weeks to 2 years) (kg change)

Dose: —

Weight:

1.00 kg change

p 0.024

Lithium in drinking water and thyroid function.

Broberg K. et al.. Environmental health perspectives 119(6) 827-30. (2011)

Cross SectionalHealthy volunteersCommunityN = 2020.00 wkRoB: Moderate

drinking water

Outcome: Body mass index (BMI) (BMI)

Dose: —

Weight:

0.14 BMI

[-0.06, 0.35]

p 0.160

Assessment of safety, tolerability and effectiveness of adjunctive aripiprazole to lithium/valproate in bipolar mania: a 46-week, open-label extension following a 6-week double-blind study.

Vieta E. et al.. Current medical research and opinion 26(6) 1485-96. (2010)

RCTBipolar IOutpatientN = 28346.0 wkRoB: High

Outcome: Mean weight change from double-blind endpoint to Week 46 (LOCF) (kg change)

Dose:

208 mg~ elem./day

Weight:

0.30 kg change

p —

Weight gain, obesity, and metabolic indices following a first manic episode: prospective 12-month data from the Systematic Treatment Optimization Program for Early Mania (STOP-EM).

Bond DJ et al.. Journal of affective disorders 124(1-2) 108-17. (2010)

Prospective CohortBipolar IOutpatientN = 4752.0 wkRoB: Serious

Outcome: Mean weight gain over 12 months (lithium vs divalproex, BMI-adjusted) (kg change)

Dose: —

Weight: —

Medical comorbidity in bipolar disorder: relationship between illnesses of the endocrine/metabolic system and treatment outcome.

Kemp DE et al.. Bipolar disorders 12(4) 404-13. (2010)

Prospective CohortBipolar IIn-/outpatientN = 22524.0 wkRoB: Serious

Outcome: BMI as predictor of depression response/remission to lithium+valproate (logistic regression)

Dose: —

Weight:

0.93

[0.87, 0.99]

p 0.020

Metabolic, digestive, and reproductive adverse events associated with antimanic treatment in children and adolescents: a retrospective cohort study.

Jerrell JM et al.. Primary care companion to the Journal of clinical psychiatry 12(4). (2010)

Retrospective CohortOtherN = 8,157RoB: Serious

Outcome: Obesity/excessive weight gain (ICD-9 diagnosis codes 278, 278.00, 278.01, 783.1, 783.2)

Dose: —

Weight:

1.89

[1.64, 2.22]

p 0.050

High prevalence of metabolic disturbances in patients with bipolar disorder in Taiwan.

Chang HH et al.. Journal of affective disorders 117(1-2) 124-9. (2009)

Cross SectionalBipolar unspecifiedOutpatientN = 117RoB: Serious

medium

Outcome: Body mass index (BMI), males (BMI)

Dose:

184 mg~ elem./day

0.67 mmol/L

Weight: —

Can body mass index help predict outcome in patients with bipolar disorder?

Calkin C. et al.. Bipolar disorders 11(6) 650-6. (2009)

Cross SectionalBipolar ICommunityN = 276RoB: Serious

Outcome: Body mass index (BMI) by lithium therapeutic effectiveness (BMI)

Dose: —

Weight:

-5.90 BMI

p 0.010

Is valproate promising in cardiac fatal arrhythmias? Comparison of P- and Q-wave dispersion in bipolar affective patients on valproate or lithium-valproate maintenance therapy with healthy controls.

Kurt E. et al.. Journal of psychopharmacology (Oxford, England) 23(3) 328-33. (2009)

Cross SectionalBipolar unspecifiedOutpatientN = 55RoB: Serious

high

Outcome: Body mass index (BMI) (BMI)

Dose:

225 mg~ elem./day

0.80 mmol/L

Weight: —

Effectiveness of lithium in children and adolescents with conduct disorder: a retrospective naturalistic study.

Masi G. et al.. CNS drugs 23(1) 59-69. (2009)

Retrospective CohortOtherIn-/outpatientN = 6036.6 wkRoB: Serious

Outcome: Weight gain in patients taking lithium as monotherapy (mean kg) (kg change)

Dose: —

Weight: —

Hospital use of antipsychotic drugs: polytherapy.

Centorrino F. et al.. Comprehensive psychiatry 49(1) 65-9. (2008)

Retrospective CohortOtherN = 3052.23 wkRoB: Serious

Outcome: Final body weight during hospitalization by antipsychotic+mood stabilizer cotreatment vs monotherapy (CPZ-eq dose analysis; weight gain associated with polytherapy)

Dose: —

Weight: —

Weight change in the acute treatment of bipolar I disorder: a naturalistic observational study of psychiatric inpatients.

Kim B. et al.. Journal of affective disorders 105(1-3) 45-52. (2008)

Prospective CohortBipolar IInpatientN = 1794.00 wkRoB: Serious

Outcome: Change in weight after 4 weeks hospitalization according to medication(s) frequently used (kg change)

Dose: —

Weight: —

Safety and tolerability of quetiapine in the treatment of acute mania in bipolar disorder.

Adler CM et al.. Journal of affective disorders 100 Suppl 1 S15-22. (2007)

RCTBipolar IN = 80912.0 wkRoB: Some Concerns

medium

Outcome: Mean change in weight from baseline (combination therapy: quetiapine+Li/DVP vs placebo+Li/DVP) (kg change)

Dose:

0.76 mmol/L

Weight:

1.70 kg change

[1.10, 2.23]

p —

A 6-month randomized open-label comparison of continuation of oral atypical antipsychotic therapy or switch to long acting injectable risperidone in patients with bipolar disorder.

Yatham LN et al.. Acta psychiatrica Scandinavica. Supplementum (434) 50-6. (2007)

RCTBipolar ICommunityN = 4926.0 wkRoB: High

Outcome: Weight

Dose: —

Weight: —

Lithium therapy for unipolar and bipolar depression among the middle-aged and older adult patient subpopulation.

Lepkifker E. et al.. Depression and anxiety 24(8) 571-6. (2007)

Retrospective CohortMixed mood disorderOutpatientN = 60503 wkRoB: Serious

Outcome: Weight gain (adverse effect during lithium treatment)

Dose: —

Weight: —

Effects of lamotrigine and lithium on body weight during maintenance treatment of bipolar I disorder.

Sachs G. et al.. Bipolar disorders 8(2) 175-81. (2006)

RCTBipolar IN = 58376.0 wkRoB: Some Concerns

Outcome: Mean change in weight (kg) from randomization day 1 to week 52 (MMRM, covariate-adjusted) (kg change)

Dose: —

Weight:

2.00 kg change

[-0.30, 4.40]

p 0.094

Adjunct divalproex or lithium to clozapine in treatment-resistant schizophrenia.

Kelly DL et al.. The Psychiatric quarterly 77(1) 81-95. (2006)

Retrospective CohortOtherInpatientN = 4926.0 wkRoB: Serious

Outcome: Weight change (pounds) over 6 months (kg change)

Dose: —

Weight:

4.60 kg change

p —

Olanzapine treatment in adolescents with severe conduct disorder.

Masi G. et al.. European psychiatry : the journal of the Association of European Psychiatrists 21(1) 51-7. (2006)

Retrospective CohortOtherIn-/outpatientN = 2338.3 wkRoB: Serious

Outcome: Weight gain at end of follow-up (kg change)

Dose: —

Weight: —

A one-year open-label trial of risperidone augmentation in lithium nonresponder youth with preschool-onset bipolar disorder.

Pavuluri MN et al.. Journal of child and adolescent psychopharmacology 16(3) 336-50. (2006)

Prospective CohortBipolar unspecifiedOutpatientN = 3852.0 wkRoB: Serious

high

Outcome: Body weight (baseline to end of study) (kg)

Dose:

150 mg~ elem./day

0.90 mmol/L

Weight: —

Atypical antipsychotic usage-related higher serum leptin levels and disabled lipid profiles in euthymic bipolar patients.

Gergerlioglu HS et al.. Neuropsychobiology 53(2) 108-12. (2006)

Cross SectionalBipolar IOutpatientN = 106RoB: Serious

Outcome: Body mass index (BMI) in mood stabilizer (MS) user patients vs controls (BMI)

Dose:

215 mg~ elem./day

Weight: —

Plasma levels of leptin and endogenous immune modulators during treatment with carbamazepine or lithium.

Himmerich H. et al.. Psychopharmacology 179(2) 447-51. (2005)

Prospective CohortMixed mood disorderInpatientN = 254.00 wkRoB: Moderate

Outcome: Body mass index (BMI) (BMI)

Dose: —

Weight: —

Longitudinal evaluation of reproductive function in women treated for bipolar disorder.

Rasgon NL et al.. Journal of affective disorders 89(1-3) 217-25. (2005)

Prospective CohortBipolar unspecifiedOutpatientN = 25104 wkRoB: Serious

Outcome: Self-reported weight gain over the prior 6 months to enrollment

Dose: —

Weight: —

Reproductive function and risk for PCOS in women treated for bipolar disorder.

Rasgon NL et al.. Bipolar disorders 7(3) 246-59. (2005)

Cross SectionalBipolar unspecifiedOutpatientN = 80RoB: Serious

Outcome: Total weight gain since treatment (lbs), by medication group (No divalproex group, which includes lithium-treated patients) (kg change)

Dose: —

Weight: —

Safety and tolerability of lamotrigine for bipolar disorder.

Bowden CL et al.. Drug safety 27(3) 173-84. (2004)

RCTBipolar IOutpatientN = 1,79276.0 wkRoB: Some Concerns

Outcome: Weight gain reported as adverse event across eight controlled trials

Dose:

166 mg~ elem./day

Weight: —

Long-term observational comparison of risperidone and olanzapine in bipolar disorder.

Ghaemi SN et al.. Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists 16(2) 69-73. (2004)

Retrospective CohortBipolar unspecifiedOutpatientN = 2965.9 wkRoB: Serious

Outcome: Weight gain (>5 lbs, clinically attributed to neuroleptic)

Dose: —

Weight:

4.29

[1.09, 16.8]

p —

Adjunctive quetiapine in bipolar patients partially responsive to lithium or valproate.

Sokolski KN et al.. Progress in neuro-psychopharmacology & biological psychiatry 27(5) 863-6. (2003)

Retrospective CohortBipolar IOutpatientN = 16RoB: Critical

high

Outcome: Weight gain (adverse event, adjunctive quetiapine)

Dose:

0.91 mmol/L

Weight: —

Valproate, bipolar disorder and polycystic ovarian syndrome.

McIntyre RS et al.. Bipolar disorders 5(1) 28-35. (2003)

Cross SectionalBipolar unspecifiedOutpatientN = 38RoB: Serious

high

Outcome: Body weight (kg) (kg)

Dose:

183 mg~ elem./day

0.92 mmol/L

Weight:

1.40 kg

p 0.820

Risperidone in acute and continuation treatment of mania.

Yatham LN et al.. International clinical psychopharmacology 18(4) 227-35. (2003)

Prospective CohortBipolar ICommunityN = 10812.0 wkRoB: Critical

medium

Outcome: Weight gain over 12-week study (mean change in body weight) (kg change)

Dose:

0.72 mmol/L

Weight: —

Obesity as a correlate of outcome in patients with bipolar I disorder.

Fagiolini A. et al.. The American journal of psychiatry 160(1) 112-7. (2003)

Prospective CohortBipolar IIn-/outpatientN = 175RoB: Serious

high

Outcome: Obesity (BMI >= 30.00 kg/m2) prevalence and its association with clinical outcomes

Dose:

0.81 mmol/L

Weight: —

Triglyceride, cholesterol and weight changes among risperidone-treated youths. A retrospective study.

Martin A. et al.. European child & adolescent psychiatry 11(3) 129-33. (2002)

Retrospective CohortOtherInpatientN = 2221.3 wkRoB: Serious

Outcome: Weight change (kg) among risperidone-treated youths (kg change)

Dose: —

Weight: —

Changes in body weight and body mass index among psychiatric patients receiving lithium, valproate, or topiramate: an open-label, nonrandomized chart review.

Chengappa KN et al.. Clinical therapeutics 24(10) 1576-84. (2002)

Retrospective CohortOtherN = 21412.7 wkRoB: Serious

Outcome: Change in body weight (kg change)

Dose:

178 mg elem./day

Weight:

7.50 kg change

p —

Thyroid abnormalities in lithium-treated patients with bipolar affective disorder.

Cayköylü A. et al.. The Journal of international medical research 30(1) 80-4. (2002)

Cross SectionalBipolar IN = 42RoB: Serious

Outcome: Weight gain (>10% increase in body weight) among patients with increased T4-to-T3 conversion

Dose:

169 mg~ elem./day

Weight: —

Endocrine effects of lithium carbonate in healthy premenopausal women: relationship with body weight regulation.

Baptista T. et al.. Progress in neuro-psychopharmacology & biological psychiatry 24(1) 1-16. (2000)

RCTHealthy volunteersN = 234.00 wkRoB: Some Concerns

low

Outcome: Body weight change during treatment (kg change)

Dose:

169 mg elem./day

0.31 mmol/L

Weight:

-0.14 kg change

p 0.890 †

An open longitudinal study of patients with bipolar rapid cycling treated with lithium or lamotrigine for mood stabilization.

Walden J. et al.. Bipolar disorders 2(4) 336-9. (2000)

RCTBipolar IIn-/outpatientN = 1452.0 wkRoB: Serious

medium

Outcome: Weight gain (adverse event, not leading to discontinuation)

Dose:

0.78 mmol/L

Weight: —

Non-adherence with long-term prophylaxis: a 6-year naturalistic follow-up study of affectively ill patients.

Schumann C. et al.. Psychiatry research 89(3) 247-57. (1999)

Prospective CohortMixed mood disorderOutpatientN = 76312 wkRoB: Serious

Outcome: Weight gain (side effect reported during 6-year follow-up)

Dose: —

Weight: —

Lack of advantage for imipramine combined with lithium versus imipramine alone in the treatment of major depression--a double-blind controlled study.

Shahal B. et al.. Biological psychiatry 40(11) 1181-3. (1996)

RCTUnipolar depression (MDD)InpatientN = 225.00 wkRoB: Some Concerns

high

Outcome: Body weight (kg)

Dose:

0.80 mmol/L

Weight: —

A Retrospective Chart Review of Lithium Side Effects in a Geriatric Outpatient Population.

Holroyd S. et al.. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry 2(4) 346-351. (1994)

Retrospective CohortMixed mood disorderOutpatientN = 114390 wkRoB: Serious

low

Outcome: Weight gain (side effect)

Dose:

0.50 mmol/L

Weight: —

Predictors of response to lithium and triiodothyronine augmentation of antidepressants in tricyclic non-responders.

Joffe RT et al.. The British journal of psychiatry : the journal of mental science 163 574-8. (1993)

RCTUnipolar depression (MDD)OutpatientN = 342.00 wkRoB: Some Concerns

medium

Outcome: Hamilton Rating Scale for Depression (HRSD) weight loss factor score — used here as the paper's primary quantitative symptom measure relevant to weight; no continuous body-weight-in-kg outcome was reported in this paper

Dose:

0.68 mmol/L

Weight: —

Side effects of chronic lithium therapy in Hong Kong Chinese: an ethnopsychiatric perspective.

Lee S.. Culture, medicine and psychiatry 17(3) 301-20. (1993)

Cross SectionalMixed mood disorderOutpatientN = 70140 wkRoB: Serious

medium

Outcome: Body Mass Index (BMI)

Dose:

208 mg elem./day

0.63 mmol/L

Weight:

1.00 BMI

p —

Carbamazepine versus lithium in the prophylaxis of bipolar affective disorder.

Coxhead N. et al.. Acta psychiatrica Scandinavica 85(2) 114-8. (1992)

RCTBipolar unspecifiedRoB: High

Outcome: Weight change (tendency to gain/lose weight) (kg change)

Dose: —

Weight: —

On the pathogenesis of abnormal involuntary movements in lithium-treated patients with major affective disorder.

Axelsson R. et al.. European archives of psychiatry and clinical neuroscience 241(1) 1-7. (1991)

Prospective CohortMixed mood disorderOutpatientN = 37801 wkRoB: Serious

low

Outcome: Body weight (kg)

Dose:

142 mg elem./day

0.56 mmol/L

Weight: —

The efficacy of low-dose lithium: clinical, psychological and biological correlates.

Abou-Saleh MT et al.. Journal of psychiatric research 23(2) 157-62. (1989)

RCTMixed mood disorderOutpatientN = 9052.0 wkRoB: Some Concerns

medium

Outcome: Change in weight during trial (kg change)

Dose:

134 mg elem./day

0.69 mmol/L

Weight: —

Long-term catamnesis on the topic of uses and side effects of lithium prevention of phasic psychoses

Koufen H. et al.. Fortschritte der Neurologie-Psychiatrie 57(9) 374-82. (1989)

Retrospective CohortMixed mood disorderCommunityN = 124676 wkRoB: Serious

medium

Outcome: Gewichtszunahme (weight gain), reported as an adverse effect at long-term follow-up (% gaining ≥7%)

Dose:

154 mg elem./day

0.63 mmol/L

Weight: —

Factors associated with discontinuation of long-term lithium treatment.

Nilsson A. et al.. Acta psychiatrica Scandinavica 80(3) 221-30. (1989)

Prospective CohortOtherOutpatientN = 64364 wkRoB: Serious

medium

Outcome: Weight gain (side effect frequency, rated by psychiatrist at 1980 investigation)

Dose:

194 mg elem./day

0.63 mmol/L

Weight: —

Lithium-induced changes in the body mass index.

Mathew B. et al.. Acta psychiatrica Scandinavica 80(6) 538-40. (1989)

Retrospective CohortMixed mood disorderOutpatientN = 117244 wkRoB: Serious

low

Outcome: Body mass index (BMI) (BMI)

Dose:

129 mg~ elem./day

0.54 mmol/L

Weight: —

Prospective studies on a lithium cohort. 3. Tremor, weight gain, diarrhea, psychological complaints.

Vestergaard P. et al.. Acta psychiatrica Scandinavica 78(4) 434-41. (1988)

Prospective CohortMixed mood disorderOutpatient364 wkRoB: Serious

medium

Outcome: Body weight change during lithium treatment (kg change)

Dose:

161 mg elem./day

0.68 mmol/L

Weight: —

Lithium, polyuria and abnormal diurnal weight gain in psychosis.

Vieweg WV et al.. Acta psychiatrica Scandinavica 78(4) 510-4. (1988)

Cross SectionalOtherN = 733.00 wkRoB: Serious

high

Outcome: Body weight (7 a.m. and 4 p.m., used to derive normalized diurnal weight gain) (kg)

Dose:

0.90 mmol/L

Weight:

1.60 kg

p —

Weight is shown in each study's own metric — kg, BMI, and “proportion gaining ≥7%” are not interchangeable, and the disagreement between them is itself a finding. “~” marks a dose inferred from an assumed carbonate salt; “†” marks a standard error derived from a reported p-value. Outcome names what the study measured, which is why a row can carry an outcome while its weight change reads “—”: the outcome was reported, but no usable between-group effect was. An empty Serum cell means the study never reported an achieved lithium level — about half of them do not — not that the level was low.