The effect of concurrent administration of psychotropic drugs and lithium on lithium ratio in bipolar patients

Abstract

There are conflicting results regarding the effect of neuroleptic drugs on lithium ratio (LR) and methodological problems may be a reason for this. The effect of concurrent use of some psychotropic agents with lithium on the LR was studied in 113 patients with bipolar mood disorder (BMD) during a prospective inpatient study by using the new direct method of measuring the erythrocyte lithium concentration (ELC). Results revealed that patients taking a combination of lithium and neuroleptics had significantly lower LR and ELC values than those on lithium alone. Such differences were not found in patients who received carbamazepine, benzodiazepines or ECT concurrently with lithium. No relationship was found between the LR and lithium dosage or duration of treatment. The plasma lithium concentration may not significantly correlate with lithium dosage or duration. The effect of neuroleptics on the LR may be mediated through a stabilizing effect on the cell membrane with a consequent reduction on lithium transport into the erythrocyte. © 1998 John Wiley & Sons, Ltd.

Lithium Erythrocyte Concentration and Neurological Toxicity in Bipolar Disorder

“…4 Two other studies demonstrated opposite results. 5,6 Although adverse effects of lithium can be seen with plasma concentrations within the therapeutic range, some patients may not respond clinically at these levels. 7 Therapeutic effects and neurological toxicity may correlate better with intra-neuronal concentrations.…”

Lithium Erythrocyte Concentration and Neurological Toxicity in Bipolar Disorder

“…4 Two other studies demonstrated opposite results. 5,6 Although adverse effects of lithium can be seen with plasma concentrations within the therapeutic range, some patients may not respond clinically at these levels. 7 Therapeutic effects and neurological toxicity may correlate better with intra-neuronal concentrations.…”

Lithium Erythrocyte Concentration and Neurological Toxicity in Bipolar Disorder

“…4 Two other studies demonstrated opposite results. 5,6 Although adverse effects of lithium can be seen with plasma concentrations within the therapeutic range, some patients may not respond clinically at these levels. 7 Therapeutic effects and neurological toxicity may correlate better with intra-neuronal concentrations.…”

Lithium Erythrocyte Concentration and Neurological Toxicity in Bipolar Disorder

“…4 Two other studies demonstrated opposite results. 5,6 Although adverse effects of lithium can be seen with plasma concentrations within the therapeutic range, some patients may not respond clinically at these levels. 7 Therapeutic effects and neurological toxicity may correlate better with intra-neuronal concentrations.…”