Mania During Maintenance Hemodialysis Successfully Treated With Oral Lithium Carbonate

Procci, Warren R.

doi:10.1097/00005053-197705000-00008

Cited by 24 publications

(19 citation statements)

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“…Since 1997, when lithium carbonate was first successfully administered orally by Procci [3] in a hemodialysis patient with bipolar affective disorders, 7 additional cases were published. A maintenance therapy with lithium carbonate at doses of between 400 and 900 mg after each hemodialysis session three times a week (table 1) was discussed to be effective [3][4][5][6][7][8][9].…”

Section: Discussionmentioning

confidence: 99%

“…A maintenance therapy with lithium carbonate at doses of between 400 and 900 mg after each hemodialysis session three times a week (table 1) was discussed to be effective [3][4][5][6][7][8][9]. These data should be interpreted with some caution, because the patients were documented with scarce details with regard to hemodialysis or comedication.…”

Section: Discussionmentioning

confidence: 99%

“…The therapeutic range of lithium is small, and serum lithium concentrations of between 0.8 and 1.2 mmol/l are reported to be effective in patients with a normal renal function [3], whereas toxicity has been described at serum lithium trough levels 12 mmol/l. In hemodialysis patients lower effective lithium levels are discussed (0.6-0.9 mmol/l) [3].…”

Section: Introductionmentioning

confidence: 99%

“…Up to now, only a few reports of therapy regimens with lithium carbonate, including !15 hemodialysis patients, are avalaible [3][4][5][6][7][8][9]. This report describes the use of lithium acetate in a hemodialysis patient.…”

Section: Introductionmentioning

confidence: 99%

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Lithium Acetate Therapy in a Maintenance Hemodialysis Patient

Walcher¹,

Schoecklmann²,

Renders³

2004

Kidney Blood Press Res

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Background/Aims: Single cases of lithium carbonate dosing in hemodialysis patients have been published. We investigate the dose-serum level relationship after single and multiple lithium acetate dosing in a hemodialysis patient and review the literature. Methods: Lithium acetate was administered orally over a period of 11 months in a patient with major depressive episodes after being placed on hemodialysis three times a week. The serum trough levels of lithium before and after hemodialysis were analyzed. The data were compared with those reported in the literature, and potential drug interactions and the importance of the residual renal function are discussed. Results: No adverse events due to the lithium therapy were documented. Steady state levels of between 0.6 and 0.8 mmol/l of lithium acetate were achieved 17 days after initiating the therapy, using 24 mmol/l of lithium three times a week, in a patient with a residual diuresis of about 400 ml/day. In contrast, data reported in the literature implicate that only 9.6–14.4 mmol/l of lithium (450–600 mg of lithium carbonate) is sufficient to achieve adequate serum levels. Conclusions: The residual renal function can be important for lithium clearance. The creatinine clearance does not reflect this point.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Lithium Acetate Therapy in a Maintenance Hemodialysis Patient

Walcher¹,

Schoecklmann²,

Renders³

2004

Kidney Blood Press Res

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“…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%

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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