			Home About us Contact

Lithium Levels (lithium + level)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Dialysis of saliva improves accuracy of saliva lithium determinations

BIPOLAR DISORDERS, Issue 1 2004
Rif S El-Mallakh
Background:, Saliva lithium (Li) determinations have been explored as a potential alternative to plasma levels. Unfortunately, this method has been shown to be unreliable. Saliva has two major components: the aqueous and the mucopolysaccharide portions. Methods:, Since Li is likely to distribute only in the aqueous fraction, we dialyzed the saliva through a 3000 Da filter to isolate the aqueous component and determine the Li level in it. Results:, Lithium levels in the dialyzed saliva agreed more closely with plasma levels (Spearman's rho = 0.901, p < 0.001) than did whole saliva (Spearman's rho = 0.775, p = 0.012). Conclusion:, Dialysis of saliva may contribute to more accurate saliva Li levels. [source]

A new accurate method for predicting lithium clearance and daily dosage requirements in adult psychiatric patients

BIPOLAR DISORDERS, Issue 3 2008
Hisham S Abou-Auda
Objective:, The present study aimed to derive new equations for estimating lithium clearance and daily dosage requirements needed to achieve an intended lithium serum level for adult psychiatric inpatients and outpatients. Methods:, Data were retrospectively collected from 60 adult psychiatric patients (34 males and 26 females, aged between 18,80 years) in both inpatient and outpatient settings. All variables that might affect lithium clearance and/or lithium serum concentration were included and analyzed by stepwise multiple linear regression to produce equations describing lithium clearance and daily dosage requirements for these patients. The validation of the developed equations was performed by application to another 60 psychiatric subjects in both the inpatient and outpatient settings. The bias and accuracy of the new methods were also compared to those set forth by the empirical method and the a priori methods developed by Zetin, Pepin, Jermain and Terao and colleagues. Results:, The following prediction equations for lithium clearance (CLLi) were obtained: CLLi (inpatients) = 0.932 + 0.185CLCr and CLLi (outpatients) = 1.021 + 0.141CLCr. The equations derived for daily dosage requirements were: daily dose (inpatients, mg) = 350.15 + 289.92 (desired lithium level, mmol/L) + 0.84 (weight, kg) , 1.76 (age, years) + 34.43 [tricyclic antidepressant (TCA), yes = 1, no = 0] + 62.1(CLCr, L/h) + 13.1 [blood urea nitrogen (BUN), mmol/L] + 40.9 (sex, male = 1, female = 0) and daily dose (outpatients, mg) = 784.92 + 530.22 (desired lithium level, mmol/L) + 8.61 (weight, kg) , 12.09 (age, years) , 11.14 (TCA, yes = 1, no = 0) , 7.63 (CLCr, L/h) , 42.62 (BUN, mmol/L) , 23.43 (sex, male = 1, female = 0). In the present method, the prediction error for clearance was 10.31% and 6.62% for inpatients and outpatients, respectively, and the prediction error for daily dosage requirements was 3.96% and 2.95% for inpatients and outpatients, respectively. Conclusions:, Compared to previously reported methods, the present method proved to be accurate and can be safely used for the prediction of lithium clearance and daily dosage requirements in psychiatric inpatients and outpatients. [source]

Requesting patterns for serum calcium concentration in patients on long-term lithium therapy

INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 1 2009
B. J. Jones
Summary Aim:, Long-term lithium therapy is associated with hypercalcaemia in 10,60% of patients, but unlike creatinine and thyroid stimulating hormone (TSH), monitoring by general practitioners of serum calcium for patients on lithium is not a requirement of the Qualities and Outcomes Framework (QOF) of 2004. We aimed to assess requesting patterns for serum calcium in patients on long-term lithium therapy and subsequent diagnosis of hypercalcaemia. Methods:, We identified 100 patients on long-term lithium therapy, as indicated by regular monitoring of lithium levels in our laboratory for at least 1 year. We determined how many of these patients had had serum calcium analysed, noting the assay date, concentration, source of request and clinical details stated. Results:, Forty-three out of hundred patients had serum calcium analysed during the course of their treatment including 28 in the previous 15 months. Twenty-one patients had serum calcium analysed by their GP, including 12 in the previous 15 months. Hypercalcaemia was diagnosed in five patients (11.6%). Conclusion:, A significant proportion of patients in whom calcium was checked developed hypercalcaemia on lithium therapy. However, only 12% of the patients had serum calcium requested by their GP in the previous 15 months, which compares unfavourably with TSH and creatinine, for which monitoring approaches 100%. We recommend that serum calcium be checked every 15 months along with creatinine and TSH. This might be achieved by incorporating appropriate targets into the QOF, or by reflective or reflex adding-on of calcium to lithium specimens from patients who have not had calcium analysed in the previous 15 months. [source]

The effects of ziprasidone on steady-state lithium levels and renal clearance of lithium

BRITISH JOURNAL OF CLINICAL PHARMACOLOGY, Issue S1 2000
G. Apseloff
Aims, To assess the potential of ziprasidone to alter the renal clearance and steady-state serum levels of lithium. Methods, Healthy subjects who had stable serum lithium levels during the first 7 days of treatment with lithium 900 mg day,,1, given as two divided daily doses, were randomized to receive concomitant treatment with either ziprasidone, 40 mg day,,1, given as two divided daily doses, on days 9,11 followed by 80 mg day,,1, given as two divided daily doses on days 12,15 (n = 12), or placebo twice daily (n = 13). Ziprasidone or placebo was administered 2 h before each dose of lithium. Results, Ziprasidone administration was associated with a 0.07 mmol l,,1 (13%) mean increase in steady-state serum lithium levels compared with a mean increase of 0.06 mmol l,,1 (10%) with placebo. Mean renal clearance of lithium decreased by 0.09 l h,,1 (5%) in the ziprasidone group and by 0.14 l h,,1 (9%) in the placebo group. None of these differences between the two groups was statistically or clinically significant. Conclusions, Ziprasidone does not alter steady-state serum lithium concentrations or renal clearance of lithium. [source]