Intraperitoneal lithium administration for bipolar affective disorder in a patient on continuous ambulatory peritoneal dialysis

Flynn, C.T.; Chandran, Prasant; Taylor, Matt; Shadur, Craig A.

doi:10.1177/039139888701000209

Cited by 14 publications

(16 citation statements)

References 4 publications

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“…Lithium may be used in patients on hemodialysis (HD) and should be administered in a single post-dialysis dose of 300–600 mg. Lithium levels should be checked pre-dialysis and 2–3 hrs following the post-dialysis dose. There is a case report in which lithium levels were maintained in the therapeutic range by intraperitoneal administration of lithium during continuous peritoneal dialysis [68]. …”

Section: Resultsmentioning

confidence: 99%

Special considerations in the treatment of patients with bipolar disorder and medical co-morbidities

McLaren

Marangell

2004

Ann Gen Hosp Psychiatry

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Background: The pharmacological treatment of bipolar disorder has dramatically improved with multiple classes of agents being used as mood-stabilizers, including lithium, anticonvulsants, and atypical antipsychotics. However, the use of these medications is not without risk, particularly when a patient with bipolar disorder also has comorbid medical illness. As the physician who likely has the most contact with patients with bipolar disorder, psychiatrists must have a high index of suspicion for medical illness, as well as a basic knowledge of the risks associated with the use of medications in this patient population.

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Section: Resultsmentioning

confidence: 99%

Special considerations in the treatment of patients with bipolar disorder and medical co-morbidities

McLaren

Marangell

2004

Ann Gen Hosp Psychiatry

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“…A review of treatment of patients with bipolar disorder and medical comorbidity [5], suggested use of lithium in a patient on haemodialysis [6] in a single post-dialysis dose of 300–600 mg and discussed a case report of intraperitoneal lithium during CAPD [7]. Carbamazepine is to be avoided due to reduced clearance of its toxic metabolite [5].…”

Section: Discussionmentioning

confidence: 99%

Treating bipolar disorder in patients with renal failure having haemodialysis: two case reports

Gupta

Annadatha

2008

Clinical Practice and Epidemiology in Mental Health

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BackgroundThere is little published guideline or evidence on treating bipolar affective disorder in patients with renal failure having haemodialysis.CaseWe present two patients with bipolar affective disorder with renal failure having haemodialysis. We used lorazepam in one patient to manage the immediate risk of non-engagement with dialysis. Risperidone was added in the second patient for managing psychotic symptoms. Valproate was started as a mood stabiliser and titrated upwards for long-term management of the illness.ConclusionWe discuss the similarities in the two cases and the care plan we used to manage them.

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“…Lithium's weil known side-effects appeared where predialysis levels exceeded 0.8 mEq/L. As expected, lithium was very effective in acute mania (Flynn et al, 1987;Oakley et al, 1974;Procci, 1977), but successful treatment of depression was also reported (Flynn et aI, 1987;Port et al, 1979). Moderate prophylactic efficacy was noted in the sole patient followed up over several years (Lippman et al , 1984).…”

Section: Introductionmentioning

confidence: 89%

“…Case reports of eleven dialysis patients receiving lithium treatment were found in the literature. Six had bipolar affective disorder (Flynn et al, 1987;Koecheler et aI., 1986;Lippman et al, 1984;Oakley et al , 1974;Port et aI., 1979;Procci, 1977), one had personality disorder (Koecheler et al, 1986), one had cluster headache (Zuddas et aI., 1985), and three were studied for research reasons (Zetin et al, 1981). All were on hemodialysis except the patient of Flynn et aI.…”

Section: Introductionmentioning

confidence: 99%

“…(1987), who was on continuous ambulatory peritoneal dialysis (CAPD). Two received lithium in dialysate; one for noncompliance (Oakley et aI., 1974) and the other for better control of lithium levels in CAPD (Flynn et al, 1987). All others received Lithiumbehandlung bei chronischer Dialyse: Literaturübersicht und FalIdarsteUung eines weiteren Hämodialysepatienten Die Literatur über die Lithiumbehandlung chronischer Dialysepatienten wird dargestellt und ein neuer Fall berichtet.…”

Section: Introductionunclassified

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Lithium Treatment in Maintenance Dialysis

Grüner

Dennert²,

Schäfer³

1991

Pharmacopsychiatry

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The literature on lithium treatment during chronic dialysis is reviewed and a new case presented. In a patient suffering from bipolar affective disorder, onset of hemodialysis precipitated a manic episode. Oral lithium, given in single postdialysis doses, was well-tolerated, effective, and easy to handle. During 19 months of constant dosing, 10.8 mEq after each dialysis maintained steady-state predialysis levels at 0.50-0.77 mEq/L. Steady-state levels of the published cases were plotted against the maintenance doses and the regression function through the origin was calculated. From this, it is concluded that the average maintenance dose (in mEq), which is 18 times the desired predialysis level (in mEq/L), might serve as a starting dose, provided predialysis levels are closely monitored and doses readjusted accordingly. Preliminary evidence suggests that one to two weeks of constant dosing are needed to achieve steady-state, but that months or even years are required to fully assess the long-term fluctuations in lithium levels.

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Intraperitoneal lithium administration for bipolar affective disorder in a patient on continuous ambulatory peritoneal dialysis

Cited by 14 publications

References 4 publications

Special considerations in the treatment of patients with bipolar disorder and medical co-morbidities

Special considerations in the treatment of patients with bipolar disorder and medical co-morbidities

Treating bipolar disorder in patients with renal failure having haemodialysis: two case reports

Lithium Treatment in Maintenance Dialysis

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