Long-term Lithium Carbonate Therapy Causes Hyperparathyroidism

Calcium and magnesium concentrations in affective disorder: difference between plasma and serum in relation to symptoms

“…During longstanding depression, both 0800 and mean diurnal serum magnesium concentrations were higher than in acute depression, remission and controls. This is consistent with the findings of others (3,4,9,11,(13)(14)(15)(16), and is considered to be an effect of lithium treatment.…”

“…Our findings for calcium are thus consistent with the workers who have used serum and also with the results of the workers who have used plasma, and indicate a difference between serum and plasma for the effects of lithium, which has not previously been noted. Magnesium concentrations at 0800, however, were higher both in plasma and serum in the lithium-treated patients, which is consistent with other studies of the effect of lithium treatment on serum magnesium (4,9,11,(13)(14)(15)(16), but not with studies of lithium effects on plasma magnesium (2,18,19). Determination of ionized calcium and magnesium and of protein levels would have been valuable for further explanation of these findings, but were not performed in this study because it was a part of a larger investigation of affective disorder.…”

“…Mean diurnal serum calcium was also higher during longstanding compared with acute depression, but 0800 serum calcium concentration was not different in these 2 groups. As 19 of the 24 patients with longstanding depression were treated with lithium (long term, mean 9.5 years), we conclude that the elevation of mean diurnal serum calcium was caused by lithium treatment, which is consistent with the findings of most other workers (4,(9)(10)(11)(12)(13)(14)(15)(16). No significant difference was found in serum calcium, comparing groups l a and l b and groups la and 2; this was considered to reflect greater fluctuations in 0800 serum calcium in acute depression, which may be caused by the effects of initiating medication, or by a phase shift in the diurnal variation of serum calcium, thus showing a greater variance for the levels at 0800.…”

“…In blood clotting, when preparing serum, one of the coagulation factors is calcium, and it must thus be assumed that calcium concentrations in serum during normal conditions are somewhat lower than in plasma, because some of the calcium initially in the liquid blood phase is bound to the clot. The findings of workers who have used serum in their electrolyte studies are mainly consistent in terms of the effects of lithium, which is considered to elevate serum levels of calcium and magnesium (4,9,(10)(11)(12)(13)(14)(15)(16). Other workers who have used plasma (2,18,19) consistently noted unchanged levels of calcium and magnesium following lithium treatment.…”

Lithium Therapy and Hyperparathyroidism: An Evidence‐Based Assessment

“…In 1981, Davis et al reported that PTH was significantly higher in 19 patients taking lithium than in 150 normal controls [49]. One year later, Franks et al reported that higher levels of serum calcium, ionized calcium, and PTH were present in 12 patients who had been taking lithium for 2–12 years when compared to age‐ and sex‐matched controls [10]. Mallette et al reported in 1989 that serum ionized calcium was higher in subjects treated long term (greater than 3 years) with lithium as compared to normal controls.…”