Lithium Toxicity and Altered Clearance Following Initiation of Semaglutide in Patients With Bipolar Disorder: A Case Series and Literature Review.

ABSTRACT:

Background

Lithium is a mainstay treatment for bipolar disorder, but its narrow therapeutic index and susceptibility to pharmacokinetic interactions make appropriate monitoring crucial. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), such as semaglutide, are increasingly prescribed for type 2 diabetes and weight management. Scarce evidence exists on the potential interaction between semaglutide and lithium.

Methods

We present 3 cases involving patients on stable lithium regimens who were initiated on semaglutide, reviewing potential mechanisms underlying the interaction between them.

Findings

In 2 cases, lithium levels increased significantly, leading to toxicity despite stable renal function and no changes in concurrent medications. In the third case, preempti

SUBMITTER: Al-Soleiti M 

PROVIDER: S-EPMC12541346 | biostudies-literature | 2025 Nov-Dec 01

REPOSITORIES: biostudies-literature