Determination of the optimal concentration of lithium for the prophylaxis of manic-depressive disorder

What is the optimal serum lithium level in the long‐term treatment of bipolar disorder – a review?

“…In the study by Waters et al. (23), 36 patients with bipolar affective disorder (DSM‐III) who had been quite successfully maintained on lithium levels of 0.6–1.2 mmol/L (no hospitalization in the two years prior to being admitted to the study, but residual mood swings), were randomized in a double‐blind cross‐over design to lithium levels of either 0.3–0.8 mmol/L or 0.8–1.4 mmol/L and were followed up for six months (duration of each study arm). While there were significantly more relapses during the low than during the high lithium level phases (p < 0.01), relapse was associated with a change in serum lithium levels rather than the actual level itself.…”

Quantitative lithium magnetic resonance spectroscopy in the normal human brain on a 3 T clinical scanner

“…Separation of the effects of age from illness is difficult because of the paucity of data from a range of healthy subjects. The current study has addressed this by investigating healthy young men receiving Li for a period consistent with its acute clinical effects (30) and to a serum level comparable with therapeutic dosing. The brain to serum ratio of 0.78 6 0.26 was consistent with estimates from similarly aged patients with bipolar disorder (13).…”

Therapeutic drug monitoring of psychotropic medications

“…Of the ®ve studies of maintenance lithium treatment, only two have found a signi®cant difference between serum concentrations. Waters et al [30] reported more relapses at low (0.3±0.8 mmol l x1 ) than high concentrations (0.8±1.4 mmol l x1 ). Gelenberg et al [31] randomly allocated bipolar patients to either`low' (0.4±0.6 mmol l x1 ) or`standard' concentrations (0.8±1.0 mmol l x1 ).…”

“…Waters et al. [30] reported more relapses at low (0.3–0.8 mmol l −1 ) than high con‐centrations (0.8–1.4 mmol l −1 ). Gelenberg et al.…”