Although a percentage of patients report cognitive side-effects when taking lithium, it can be difficult to determine from the literature whether any cognitive changes reflect lithium itself, the lithium serum level, residual mood symptoms, the underlying nature of bipolar disorder, or biological alterations such as hypothyroidism. This review was carried out to synthesize and evaluate relevant literature examining any cognitive impact of lithium in those with bipolar disorder. The effect of lithium in those with bipolar disorder was examined across the cognitive domains of attention, psychomotor speed, processing speed, working memory, intellectual functioning, verbal memory, visual memory, and executive functioning by reviewing the published empirical literature. Any impact of hypothyroidism and lithium toxicity was also examined. The literature supports the conclusion that lithium has a distinct impact on psychomotor speed in participants with bipolar disorder. In contrast, there appears to be no impact on attention. Any impact of lithium on memory in patients with bipolar disorder is unclear as the literature is contradictory and any such effect may be overshadowed by the greater impact of residual mood symptoms. The impact on processing speed, intellectual abilities, and executive functioning also remains unclear. Several clinical management strategies are recommended.

中文翻译：

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躁郁症患者的锂和认知能力。

尽管有一定比例的患者报告服用锂时有认知副作用，但从文献中很难确定是否有任何认知变化反映出锂本身，锂血清水平，残留的情绪症状，躁郁症的内在本质或生物学改变如甲状腺功能减退。进行了这项综述，以综合和评估相关文献，研究锂对双相情感障碍患者的任何认知影响。通过回顾已发表的经验文献，研究了锂在双相情感障碍患者中的​​作用，涉及注意力，精神运动速度，处理速度，工作记忆，智力功能，语言记忆，视觉记忆和执行功能等认知领域。还检查了甲状腺功能减退和锂中毒的任何影响。文献支持以下结论：锂对双相情感障碍参与者的心理运动速度有明显影响。相反，似乎对注意力没有影响。锂对双相情感障碍患者记忆力的影响尚不清楚，因为文献是相互矛盾的，残余情绪症状的更大影响可能会掩盖任何此类影响。对处理速度，智力和执行功能的影响也尚不清楚。建议使用几种临床管理策略。锂对双相情感障碍患者记忆力的影响尚不清楚，因为文献是相互矛盾的，残余情绪症状的更大影响可能会掩盖任何此类影响。对处理速度，智力和执行功能的影响也尚不清楚。建议使用几种临床管理策略。锂对双相情感障碍患者记忆力的影响尚不清楚，因为文献是相互矛盾的，残余情绪症状的更大影响可能会掩盖任何此类影响。对处理速度，智力和执行功能的影响也尚不清楚。建议使用几种临床管理策略。