-Serotonin has an important role in the development of depressive disorders. Bearing in mind that direct testing of central nervous system is unavailable to researchers due to the inability to reach the samples, ever greater attention is given to the peripheral systems that can help us diagnose and detect changes of the disease, but also follow the course of its treatment and recovery. Thrombocyte is a blood cell that contains serotonin lodged in its delta granules. Thrombocyte serotonin system is similar, although not the same as the serotonin system in central nervous system. The most important differences are that in thrombocytes, serotonin is broken down by the enzyme monoaminooxidase B (MAO-B), while that function in neuron is carried out by monoaminooxidase A (MAO-A) and that a thrombocyte cannot synthetize serotonin itself, because it lacks tryptophan hydroxylase. Nowadays, in the treatment of depressive disorders, mostly the selective inhibitors of serotonin uptake (SIPPS) are being used. The research has proved that therapy with those medications changes the concentration of serotonin in thrombocytes and changes the values of some thrombocyte indices. The thrombocyte serotonin is a powerful vasoconstrictor, which increases the cardiovascular risk and the probability of thrombogenesis. The mean volume of thrombocytes (MPV) is a positive index of thrombocyte activity and the increase of MPV represents an independent risk factor for the development of cardiovascular diseases. It is of enormous significance to recognize the depression in patients who suffer from cardiovascular diseases. Depression interferes with the recovery of those patients, because it reduces the personal engagement in it and disturbs patients' compliance and the motivation for treatment. Besides the fact that the treatment with SIPPS leads to the regression of symptoms of depression, it also changes the concentration of thrombocyte serotonin and the mean volume of thrombocytes towards the values that reduce their role in pathogenesis of cardiovascular diseases, thus reducing the risk of re-occurrence of cardiovascular incidents and improving the patients' recovery.
Abstract-The use of lithium in medicine began in the mid-19th century, when the solubility of uric acid salts in the solution of lithium carbonate was demonstrated in vitro, which meant that lithium could be used in the treatment of gout. The use of lithium in psychiatry starts in 1949, when the effect of lithium in the treatment of mania was demonstrated. The mechanism of action of lithium is not yet completely understood. In parallel with the use of lithium in the treatment of psychiatric disorders, different methods for the determination of lithium in human samples have been developed. The first aim of the study was to determine the amount of lithium in serum samples using electrochemical methods, flame photometry and spectrophotometry and use the results to compare the results obtained using these methods. Because of the possibility of determining lithium in various media, the second aim of the study was to evaluate the clinical value of determining the concentration of lithium in erythrocytes in relation to the concentration of lithium in plasma. The third aim was to investigate the extent to which a therapeutic dose of lithium correlates with the measured concentrations of lithium in serum, plasma and erythrocytes. It was concluded that statistically there was no significant difference between the three test laboratory methods (P = 0.507). Investigating the correlation between the concentration of lithium in various media measured by different methods and the daily therapeutic dose of lithium, it was concluded that statistically a significant correlation was found only in serum lithium concentrations measured with electrochemical method (P = 0.009; r = 0.47). There was statistically a significant moderate correlation between the concentration of lithium in plasma and erythrocytes (P = 0.002; r = -0.54), and the lithium concentration erythrocytes are higher than lithium concentrations in plasma (P = 0,043). The range of the ratio of the concentration of lithium in erythrocytes and plasma is wide (13.25 to 111.15), and is not in correlation with the therapeutic daily dose and therefore is not a better indicator in the control of the treatment.
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