Lithium use during pregnancy in a patient with bipolar disorder and multiple sclerosis

Although lithium is widely employed as a first-line treatment for mood disorders, its mood-stabilizing effects remain not fully understood. A growing body of data is stressing that lithium seems to show broader properties, including neuroprotective and neurogenetic effects. Its possible role in ameliorating neurodegenerative diseases has also been reported in literature. Intriguingly, some autoimmune and/or neurodegenerative diseases, such as Multiple Sclerosis (MS), seem to show a significant relationship with mood disorders, in terms of genetic liability and comorbidity. Although only a small number of studies specifically investigated the role of lithium in Multiple Sclerosis (MS), first evidence seems to support its possible therapeutic role also in this condition. On the other hand, although lithium has been associated to a high teratogen risk, thus limiting its use during pregnancy, recent studies stressed how the risks of lithium use in pregnancy may be more limited than previously reported. The aim of this article is to report the effects of lithium treatment in a 43-years-old woman with bipolar disorder and MS during lifetime, with a specific focus on the pregnancy period. This case further supports the safety of lithium and its potential properties in neurodegenerative diseases. Possible implications for both clinical practice and research are discussed, in the framework of an integrative approach between central and peripheral systems.