Research Article

Renal and Hepatic Biochemical Trajectories During Lithium and Valproate Treatment in Bipolar Disorder

Volume: 17 Number: October, November, December 2026 October 21, 2026

Renal and Hepatic Biochemical Trajectories During Lithium and Valproate Treatment in Bipolar Disorder

Abstract

Purpose: To compare within-person renal and hepatic biochemical trajectories during lithium and valproate treatment in bipolar disorder and determine whether longitudinal slopes differed between treatment groups. Methods:This single-center retrospective cohort included 96 patients with bipolar disorder treated with lithium (n=35) or valproate (n=61), contributing 282 laboratory records. Random-intercept linear mixed-effects models for creatinine, blood urea nitrogen (BUN), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) included age at the first available laboratory record, sex, time, treatment group, and the time × treatment interaction. Outcome-specific adjusted models comprised 275-278 observations from 95 patients. For creatinine, a treatment-specific piecewise model with a 6-month knot was supplemented by data-quality and random-slope sensitivity analyses. Results: Mean follow-up was 312.22 ± 199.21 days. The time × treatment interaction was not statistically significant for creatinine (B=-0.0019, p=.303), BUN (B=-0.0853, p=.160), AST (B=-0.0070, p=.285), or ALT (B=-0.0059, p=.442). Male sex was associated with higher creatinine, AST, and ALT levels, whereas older baseline age was associated with higher BUN. In the piecewise model, neither early nor late slopes differed by treatment (joint Wald χ²(2)=0.544, p=.762). All sensitivity analyses supported the primary finding. Conclusion: No statistically detectable difference was observed between lithium and valproate groups in the longitudinal slopes of the evaluated markers. The findings do not establish equivalence or long-term safety; average short- to mediumterm trajectories did not diverge under regular, individualized laboratory monitoring.

Keywords

Supporting Institution

None. This study received no financial support.

Ethical Statement

This retrospective study was approved by the Non-Interventional Scientific Research Ethics Committee of Tokat Gaziosmanpaşa University Faculty of Medicine (Decision No: 25-MOBAEK-355; date: October 14, 2025). The study was conducted in accordance with the principles of the Declaration of Helsinki.

Thanks

Not applicable.

References

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Details

Primary Language

English

Subjects

Psychiatry

Journal Section

Research Article

Publication Date

October 21, 2026

Submission Date

August 3, 2026

Acceptance Date

September 7, 2026

Published in Issue

Year 2026 Volume: 17 Number: October, November, December 2026

APA
Güneysu, İ., Aydın, S., & Eser, B. (2026). Renal and Hepatic Biochemical Trajectories During Lithium and Valproate Treatment in Bipolar Disorder. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, 17(October, November, December 2026). https://doi.org/10.31067/acusaglik.2009917
AMA
1.Güneysu İ, Aydın S, Eser B. Renal and Hepatic Biochemical Trajectories During Lithium and Valproate Treatment in Bipolar Disorder. Acibadem Univ Saglik Bilim Derg. 2026;17(October, November, December 2026). doi:10.31067/acusaglik.2009917
Chicago
Güneysu, İlker, Sare Aydın, and Burcu Eser. 2026. “Renal and Hepatic Biochemical Trajectories During Lithium and Valproate Treatment in Bipolar Disorder”. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 17 (October, November, December 2026). https://doi.org/10.31067/acusaglik.2009917.
EndNote
Güneysu İ, Aydın S, Eser B (October 1, 2026) Renal and Hepatic Biochemical Trajectories During Lithium and Valproate Treatment in Bipolar Disorder. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 17 October, November, December 2026
IEEE
[1]İ. Güneysu, S. Aydın, and B. Eser, “Renal and Hepatic Biochemical Trajectories During Lithium and Valproate Treatment in Bipolar Disorder”, Acibadem Univ Saglik Bilim Derg, vol. 17, no. October, November, December 2026, Oct. 2026, doi: 10.31067/acusaglik.2009917.
ISNAD
Güneysu, İlker - Aydın, Sare - Eser, Burcu. “Renal and Hepatic Biochemical Trajectories During Lithium and Valproate Treatment in Bipolar Disorder”. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 17/October, November, December 2026 (October 1, 2026). https://doi.org/10.31067/acusaglik.2009917.
JAMA
1.Güneysu İ, Aydın S, Eser B. Renal and Hepatic Biochemical Trajectories During Lithium and Valproate Treatment in Bipolar Disorder. Acibadem Univ Saglik Bilim Derg. 2026;17. doi:10.31067/acusaglik.2009917.
MLA
Güneysu, İlker, et al. “Renal and Hepatic Biochemical Trajectories During Lithium and Valproate Treatment in Bipolar Disorder”. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, vol. 17, no. October, November, December 2026, Oct. 2026, doi:10.31067/acusaglik.2009917.
Vancouver
1.İlker Güneysu, Sare Aydın, Burcu Eser. Renal and Hepatic Biochemical Trajectories During Lithium and Valproate Treatment in Bipolar Disorder. Acibadem Univ Saglik Bilim Derg. 2026 Oct. 1;17(October, November, December 2026). doi:10.31067/acusaglik.2009917