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PubMed1986

Proenkephalin-A gene regulation in the rat striatum: influence of lithium and haloperidol.

This report explores the influence of lithium and haloperidol on (Met5)-enkephalin (ME) biosynthesis in the rat striatum. Male Fischer 344 rats were treated intraperitoneally with lithium chloride (4 mEq/kg/day) for 2, 4, or 6 days and sacrificed 24 hr after the last dose; in addition, the effect of lithium at 2 and 24 hr after a single dose was studied. Serum levels increased in a time-related manner on repeated administration of lithium. Lithium increased the striatal ME content (native ME) in a time-dependent fashion, reaching 160% of control following six doses; no changes in ME were observed in hypothalamus and hippocampus. ME levels recovered to control values 8 days after cessation of a 4-day course of repeated administration (4 mEq/kg/day) of lithium. In an attempt to characterize the nature of this selective increase of ME content in the striatum, the precursor content (cryptic ME) as well as the preproenkephalin mRNA abundance was determined. Lithium increased the precursor content in a time-dependent fashion and this pattern closely paralleled the increase in native ME content. The preproenkephalin mRNA abundance with respect to control was quantitated by blot-hybridization of total RNA with a 32P-labeled cDNA probe derived from rat brain. Lithium increased the mRNA abundance following repeated doses for 4 or 6 days. Concurrent administration of an opiate antagonist, naltrexone (5 mg/kg/day), for 4 days did not influence the changes induced by lithium. On repeated administration (1 mg/kg/day) for 4 days, the neuroleptic, haloperidol, increased the biosynthesis of ME which was more marked than that of lithium administered for the same period; the combination of a haloperidol and lithium regimen did not lead to an additive of synergistic effect. The results indicate that, like haloperidol, repeated injections of lithium increase the biosynthesis of ME in the basal ganglia by increasing the preproenkephalin mRNA abundance and translation process.

Animals↗
PubMed1994

Single-dose bioavailability of two extended-release lithium carbonate products.

The single-dose bioavailabilities of two extended-release lithium carbonate products and an immediate-release product were compared. Nonsmoking healthy volunteers ages 20-31 (n = 12) were randomly assigned to one of three groups and given three treatments, each separated by a one-week period. The treatments, which were given to each group in a different sequence, consisted of three 300-mg immediate-release lithium carbonate tablets (Lithotab), two 450-mg extended-release lithium carbonate tablets (Eskalith CR), and three 300-mg extended-release lithium carbonate tablets (Lithobid). Blood samples were collected just before drug administration and at intervals up to 48 hours afterward. Urine was collected for 96 hours. Plasma and urine lithium concentrations were determined by flame-emission spectrophotometry, and lithium pharmacokinetic values and the cumulative urinary excretion of lithium were computed. Mean maximum plasma lithium concentration (Cmax) differed significantly among all three lithium carbonate products. Eskalith CR produced a 40% lower Cmax and Lithobid a 25% lower Cmax than Lithotab; Lithobid produced a 23% higher Cmax than Eskalith CR. Lithotab had a significantly shorter mean time to maximum plasma lithium concentration than either extended-release product. Mean cumulative urinary excretion of lithium did not differ significantly among the three products. Two extended-release lithium carbonate products were not bioequivalent when given in single doses to healthy volunteers.

Adult↗
PubMed1975

In vitro and in vivo transport of lithium by human erythrocytes.

An in vitro system that can be used to measure both uptake and efflux of lithium by erythrocytes (RBCs) is described. Using this system, RBC lithium accumulation in vitro was compared with in vivo RBC lithium concentrations observed in 6 normal volunteers. A significant correlation was demonstrated between in vitro RBC lithium accumulation after 48-hr incubation and in vivo RBC lithium concentration at 24, 48, 72, and 96 hr following the beginning of lithium ingestion. In addition, when efflux of lithium from RBCs in vitro was studied, a significant correlation was observed between residual lithium in RBCs and in vitro RBC lithium accumulation. Finally, it has been demonstrated that storage of blood in ice for 5 hr prior to incubation with lithium results in increased RBC lithium accumulation. A potential role for this in vitro incubation system as a model for in vivo RBC lithium accumulation is suggested.

Adult↗
PubMed1996

Pharmacokinetic interaction between multiple-dose venlafaxine and single-dose lithium.

Venlafaxine is a structurally novel antidepressant. Because lithium and antidepressants may be administered concomitantly, it is important to determine whether the disposition of venlafaxine and lithium is affected by coadministration. An open-label study was conducted to evaluate the effects of multiple-dose, steady-state venlafaxine administration on the pharmacokinetics of a single oral dose of lithium. Analogously, the effects of administration of a single-dose of lithium on the disposition of venlafaxine and its active metabolite, O-desmethylvenlafaxine, after multiple-dose administration of venlafaxine were assessed. Administration of 600 mg lithium carbonate did not affect venlafaxine absorption. Lithium significantly reduced the renal clearance of venlafaxine from 0.053 to 0.027 L/h/kg. However, renal excretion is not a major elimination pathway for venlafaxine; thus, lithium did not affect the total clearance of venlafaxine. Lithium administration had similar effects on elimination of O-desmethylvenlafaxine. Multiple-dose administration of 50 mg of venlafaxine every 8 hours produced a slight increase in the rate of lithium absorption, but did not affect the extent of lithium absorption. Total clearance (0.026 L/h/kg) and steady-state volume of distribution (0.71 L/kg) of lithium were not affected by administration of venlafaxine. Thus, there were no clinically significant pharmacokinetic interactions between venlafaxine and lithium.

Administration, Oral↗
PubMed1976

Current determination of lithium-induced minimum sodium requirement in rats.

Lithium administration raises the minimum sodium requirement of the organism. Lithium treated-rats drink spontaneously a hypertonic sodium chloride solution and thereby protect themselves against the toxic effects of lithium. In the present paper it was studied whether the consumption of sodium chloride can be used as a quantitative measure of the sodium requirement. Rats given different amounts of lithium with food for about 2 months were given free access to water and a 0.46 M NaCl solution, and the 24-h intake of the latter was followed. It was found that the consumption of hypertonic sodium chloride increased with the lithium dosage and the serum lithium level. The consumption showed the following characteristics: (a) It was sufficient to prevent death from lithium poisoning. (b) When access to hypertonic chloride was discontinued for 48 h, the rats lost body weight; the body weight was reestablished within 1 h when the rats again had access to sodium chloride solution. (c) When sufficient amounts of sodium were given with the food, the lithium-treated rats drank no more sodium chloride solution than did the control rats. (d) When lithium administration was discontinued, the consumption of sodium chloride solution fell within 10 days to the control level. (e) The lithium-treated rats developed polyuria, but this was not the cause of the extra intake of sodium chloride. (f) The lithium-treated rats did not drink more of the hypertonic sodium chloride solution than was necessary to cover the minimum sodium requirement. The results indicate that the intake of hypertonic sodium chloride solution can, in fact, be used as a measure of the minimum sodium requirement in lithium-treated rats.

Animals↗
PubMed1982

Cellular lithium and transepithelial transport across toad urinary bladder.

Toad urinary bladders were exposed on either their mucosal or serosal surfaces, or on both surfaces, to medium in which sodium was replaced completely by lithium. With mucosal lithium Ringer's, serosal sodium Ringer's, short-circuit current (SCC) declined by about 50 percent over the first 60 min and was then maintained over a further 180 min. Cellular lithium content was comparable to the sodium transport pool. With lithium Ringer's serosa, SCC was abolished over 60 to 120 min whether the mucosal cation was sodium or lithium. Measurements of cellular ionic composition revealed that the epithelial cells gained lithium from both the mucosal and serosal media. With lithium Ringer's mucosa and serosa, cells lost potassium and gained lithium and a little chloride and water, but these changes in cellular ions could not account for the current flow across the tissue under these conditions, which must, therefore, have been carried by a transepithelial movement of lithium itself. The inhibition by serosal lithium of SCC was overcome by exposure of the mucosal surface of the bladders to amphotericin B. Thus it reflected, predominantly, an inhibition of lithium entry to the cells across the apical membrane. It is suggested that this inhibition is a consequence of cellular lithium accumulation.

Amiloride↗
PubMed2001

Arguments for the specificity of the antisuicidal effect of lithium.

UNLABELLED: Affective disorders are characterized by first a high recurrence risk, second a 30-50 times increased suicide risk and third a 2- to 3 times increased overall mortality. In contrast to a populistic belief no scientific evidence exists that antidepressant treatment, particularly long-term treatment, could reduce the the risk of suicidal acts in depressive patients with a history of suicide attempts. Data, however, coming from international, systematic, retrospective analyses of well-documented long-term courses of illness in reliably diagnosed patients, and from a large national, prospective long-term trial on the prophylactic efficacy of lithium versus carbamazepine and amitriptyline has accumulated in the last 10-15 years strongly supporting a (possibly specific) antisuicidal effect of lithium. The large collaborative IGSLI study (International Group for the Study of Lithium-treated Patients) covering 5,616 patient years clearly showed that adequate long-term lithium treatment significantly reduces and even normalizes the excess mortality of patients with affective disorders. A metaanalysis on 17,000 patients pooled from 28 studies demonstrated that the rate of suicidal acts is 8.6 fold higher in patients without lithium as compared to those with regular lithium treatment. A post-hoc analysis of a large multicenter, controlled long-term trial found no suicidal acts in 146 patients randomized to lithium compared to 9 suicidal acts in 139 patients randomized to carbamazepine. Reanalysis of the data from the IGSLI study supports the concept of the specificity of lithium, i.e., evidence could be provided that lithium also reduces suicidal behavior in patients who do not benefit from the lithium treatment in terms of episode reduction. CONCLUSION: Lithium has to be considered as a first line mood stabilizer in affective disorders, particularly in patients with a history of suicide attempts. Extreme caution is required when lithium is discontinued or a patient is switched to another mood stabilizer, because such a patient might have been protected against suicidal impulses in spite of an incomplete response as to the number and quality of depressive/manic episodes.

Antimanic Agents↗
PubMed1998

Augmentation of lithium's behavioral effect by inositol uptake inhibitors.

Lithium inhibits the enzyme inositol monophosphatase and thus obstructs the enzymatic degradation of inositol triphosphate (IP3) to inositol in the phosphate-phosphoinositide (PIP) cycle. This inhibition may result in reduced availability of the second messengers IP3 and DAG that are derivates of the PIP cycle, and this action is currently a leading hypothesis regarding lithium's therapeutic and prophylactic effect in affective disorders. Inositol is also available to the cell by uptake from the intercellular matrix, and therefore it is possible that compounds that block the uptake may have lithium-like effects. To test this hypothesis, the present study evaluates the effects of two inositol uptake inhibitors, the carbohydrate L-fucose and the cyclodepsipeptide nordidemnin, in a behavioral model of pilocarpine-induced seizures known to be enhanced by lithium. We tested the possibility that L-fucose produces lithium-like effects, or that L-fucose or nordidemnin augment lithium's behavioral effects. Results indicate that acute ICV treatment with L-fucose did not by itself have a lithium-like effect in the behavioral model, but significantly augmented lithium's effect when combined with lithium treatment. Nordidemnin treatment showed similar effects. The results suggest that when inositol monophosphatase is inhibited by lithium, further restriction of cellular inositol availability may result in an augmentation of lithium's behavioral effects. It is possible that such manipulations may be applicable in the treatment of patients with affective disorders, especially patients who are poor responders to lithium monotherapy.

Animals↗
PubMed1982

A clinico-pathological study of lithium nephrotoxicity.

Lithium salts, well recognised as acute nephrotoxins, have recently been implicated in the development of a chronic focal interstitial nephropathy. As part of a clinico-pathological study of lithium nephrotoxicity, renal function and renal histology has been compared between 25 patient on maintenance lithium therapy and 19 patients with affective illnesses prior to commencement of lithium therapy. Significant evidence of chronic renal damage was present in biopsies of lithium treated patients when compared with cadaveric donor kidneys (p less than 0.001). Similar damage was noted in biopsies from patient prior to lithium and differed from donor kidneys (p less than 0.01). The degree of damage was not significantly different between the patients on lithium and those not yet on lithium. An acute specific tubular lesion was note in patients on lithium, and a marked degree of distal tubule dilation and microcyst formation were also observed. Significant defects in urinary concentrating ability and urinary acidification were present in patients on lithium and there was a correlation between the degree of these defects and the duration of lithium therapy. There was no evidence of a substantial reduction in glomerular filtration rate, which could be ascribed to the lithium therapy.

Adult↗
PubMed2006

Enhancing effects of chronic lithium on memory in the rat.

BACKGROUND: In spite of recent enrichment of neurochemical and behavioural data establishing a neuroprotective role for lithium, its primary effects on cognitive functioning remain ambiguous. This study examines chronic lithium effects on spatial working memory and long-term retention. METHODS: In three discrete experiments, rats subjected to 30 daily intraperitoneal injections (2mmol/kg) of lithium (lithium groups: serum lithium=0.5+/-0.4mEq/l, 12h post-injection) or saline (controls) were trained in 0-s delay T-maze alternation and then tested in 30-, 45- and 60-s delay alternation (Experiments 1, 2, 3, respectively). Animals from Experiment 1 were further tested in one-trial step-through passive avoidance under mild shock parameters (0.5mA, 1s). Retention was assessed 6h later. Daily lithium or saline injections continued throughout behavioural testing. RESULTS: Lithium animals were indistinguishable from controls during 0-delay alternation baseline (Experiments 1-3, accuracy>88%) but showed significantly higher accuracy than controls at 30- and 45-s delays (93% versus 85% and 92% versus 82%, Experiments 1 and 2, respectively). At 60-s delay (Experiment 3) this beneficial effect of lithium was no longer apparent (lithium and control accuracy=78%). In Experiment 4, the shock used did not support 6-h passive avoidance retention in controls, whereas lithium animals showed significant step-through latency increases. CONCLUSIONS: Chronic lithium enhanced spatial working memory and promoted long-term retention of a weak aversive contingency. The results suggest that lithium may have potential as a cognitive enhancer.

Analysis of Variance↗
PubMed2005

Differences in hypothyroidism between lithium-free and -treated patients with bipolar disorders.

The majority of the previous studies of thyroid abnormalities in bipolar patients was conducted in populations containing various proportions of lithium-treated subjects. In the present study, we sought to determine whether there exist differences in hypothyroid profile between lithium-free and -treated bipolar patients. Bipolar patients never treated with lithium and carbamazepine (n=78) and those currently in lithium therapy (n=53) were included in this study. Serum concentrations of total thyroxine (T(4)), total triiodothyronine (T(3)), and thyroid-stimulating hormone (TSH) were compared between lithium-free and -treated patients. The rate of hypothyroidism in lithium-free patients was significantly lower than those treated with lithium (6.3%-10.8% vs. 28.0%-32.1%). Significant changes in the three thyroid indices indicative of hypothyroidism were consistently associated with longer illness duration in lithium-free manic patients, but with greater severity of mania and more mood episodes in their lithium-treated counterparts. In lithium-free depressed patients, more episodes were associated with lower T(4) levels; whereas in their lithium-treated counterparts, longer illness duration was associated with higher TSH levels and females with lower T(3) levels. These results suggest that bipolar patients with and without lithium exposure differ in prevalence and association of hypothyroidism and may have different response to thyroid hormone therapy.

Adult↗
PubMed1986

Evidence for an intestinal lithium excretion in rats.

Renal, biliary, and faecal lithium excretion as well as intracellular lithium concentrations in different segments of the intestine were measured simultaneously in anaesthetized adult rats following sham operation, after ligation of the hilus of one or both kidneys, and after bilateral ligation of the renal hilus and additional bile duct ligation. Lithium was administered intravenously (300 mumol/100 g b.wt.) and thereafter lithium, sodium and potassium were measured up to 3 h in the different biological materials. The results give evidence that only one fifth of the lithium determined in faeces reached the small intestine via bile. Dependent on the type of restricted elimination, an increased lithium content was measured in faeces, which was distinctly higher in the colon than in the two small intestine segments. In contrast, no changes in biliary lithium excretion were observed. A slower decrease in the time course of serum lithium concentrations demonstrated that the loss of the other elimination routes cannot be compensated completely by the enhanced faecal lithium output. But lithium concentrations were found to be lower in serum than in the intestinal tissue segments and were highest in the segmental samples of faeces. On this basis an active transcellular transport step for lithium must be supposed beside the possibility of a paracellular transfer across the intestine. The lithium-induced changes of the sodium and potassium concentrations observed in the intestinal tissue and in the faeces support this interpretation.

Animals↗
PubMed2003

Lack of effect of amisulpride on the pharmacokinetics and safety of lithium.

Lithium may be used as adjuvant therapy in schizophrenic patients and antipsychotics can be employed during the early phases of lithium therapy in patients with bipolar disorder. The issue of interactions between lithium and antipsychotics is therefore important. This study investigates the potential influence of repeated administration of amisulpride, an atypical antipsychotic, on the pharmacokinetics of lithium at steady state. Twenty-four healthy male volunteers (aged 1833 yr) received lithium carbonate (500 mg b.i.d.) for 14 d. All subjects were shown to have stable lithium serum concentrations after 57 d and were then randomized to receive double-blind administration of amisulpride (100 mg b.i.d.) or placebo bid from day 8 of lithium administration. Complete pharmacokinetic profiles were obtained on days 7 and 14 for lithium and trough plasma concentrations on days 10, 12 and 14 for amisulpride. Co-administration of amisulpride appeared to exert no effect on the pharmacokinetics of lithium. All treatments were well tolerated and safety assessment revealed no differences between the lithium+placebo and lithium+amisulpride groups. This finding permits the flexible use of amisulpride in patients already receiving lithium therapy.

Adolescent↗
PubMed2006

Restraint stress influences AP-1 and CREB DNA-binding activity induced by chronic lithium treatment in the rat frontal cortex and hippocampus.

The therapeutic efficacy of mood stabilizers may involve the regulation of gene expression mediated by transcription factor activation. In this study, we investigated AP-1 and cAMP response element-binding protein (CREB) DNA-binding activity in the rat frontal cortex and hippocampus of rats fed a control diet, a lithium diet for 7 wk, or 6 wk of lithium, followed by withdrawal for 7 d. Subsequently, animals were exposed to restraint stress or no stress and the DNA-binding activities assessed at 2, 8 and 24 h post-stress. AP-1 activity was increased in both brain regions by lithium, an effect that persisted with lithium discontinuation. Restraint stress induced AP-1 activity in the frontal cortex of the control group. This stress-induced effect on AP-1 activity was attenuated in lithium-treated and lithium-withdrawn animals. AP-1 DNA binding was also induced by stress in the hippocampus of control animals and the activity diminished over time in the lithium and lithium-withdrawn groups. CREB activity also increased in the frontal cortex and hippocampus of the lithium-treated group. Stress increased CREB activity in the frontal cortex of the controls, and was slightly attenuated with lithium treatment. CREB activity in the hippocampus was insensitive to stress. The proteins involved in the AP-1 and CREB transcription complexes were also characterized. Our findings of increased AP-1 and CREB binding after lithium are consistent with lithium's inhibitory effect on glycogen synthase kinase-3beta, which has been show to negatively regulate AP-1 and CREB transcriptional activity.

Analysis of Variance↗
PubMed1999

Effect of lithium augmentation on the trace elemental profile in diabetic rats.

Energy dispersive X-ray fluorescence technique was employed to study the interactions among various elements, viz.: K, Zn, Br, Fe, Cu, Br & Rb in 4 groups of rats viz. control-GI, diabetic-GII (diabetes induced by i.p. administration of alloxan monohydrate at a dose level of 150 mg/kg b.w; single injection), lithium treated-GIII (lithium administered as Li2 Co3 at a dose level of 1.1 g of Li2 Co3/kg animal diet; free access; serum lithium levels--0.5-1.2 mEq/L) and lithium + diabetic rats-GIV. The different treatments continued for a total duration of 1 month. The K contents were found to be significantly lowered in all the treatment groups which was maximum (28%) in lithium treated diabetic rats. Depression in the levels of Rb was noticed in lithium treated and lithium treated diabetic (G-III and G-IV) groups. However, the levels (Rb) remained unaltered in diabetic (G-II) group. Interestingly, a significant decline was observed in Fe levels in G-III following lithium administration but the levels remained unchanged in G-IV with lithium administration to diabetic rats. On the other hand, lithium treatment to normal (G-III) and diabetic (G-IV) rats indicated statistically significant elevation in the levels of Cu and Br. However, diabetic (G-II) rats did not indicate any elevation in the levels of these two elements. Interestingly, the concentrations of Zn were found to be significantly elevated in all the treatment groups, which was maximum (37%) in G-III (lithium) group. A comparison of various elements from lithium treated diabetic group G-IV with the corresponding elements from the diabetic group G-II, implied a significant depression in K and Rb levels and a significant elevation in the levels of Br.

Animals↗
PubMed2001

The prophylactic effect of long-term lithium administration in bipolar patients entering treatment in the 1970s and 1980s.

OBJECTIVES: The aim of the study was to assess the prophylactic effect of long-term lithium administration in patients with bipolar mood disorders entering treatment in the 1970s and 1980s at the outpatient clinic of the Department of Psychiatry, University of Medical Sciences, Poznan, Poland. METHODS: The clinical characteristics of two groups of patients before and during lithium therapy were compared, namely, the 60 bipolar patients who entered lithium prophylaxis in the 1970s and 49 patients who entered in the 1980s. Both groups received the drug over a 10-year period. RESULTS: The patients who entered lithium in the 1970s had fewer previous episodes of depression and more of mania than the patients who entered the therapy in the 1980s, although the total number of affective episodes was similar in both groups. The overall prophylactic efficacy of lithium over a 10-year period of administration was similar in both groups, except for a trend towards a greater number of depressive episodes in the first year of lithium prophylaxis in the 1980s group. The excellent lithium responders constituted 35% of the 1970s patients and 27% of those in the 1980s group. The 1970s patients were maintained on a higher level of serum lithium compared to the patients in the 1980s group and had more lithium-induced side effects. CONCLUSIONS: A decrease in lithium prophylactic efficacy in consecutive decades was not observed. Small differences between the bipolar patients entering lithium therapy in the 2 decades were observed in terms of the previous history of illness and during the course of lithium administration.

Adult↗
PubMed1992

Lithium pretreatment affects renal and systemic responses to angiotensin II infusion in normal man.

1. Renal and systemic responses to infusion of angiotensin II (1.25 and 2.5 ng min-1 kg-1 body weight) were examined in ten normal males 12 h after single doses of 750 mg of lithium carbonate, 250 mg of lithium carbonate (n = 6) or placebo. 2. Baseline mean arterial pressure [mean (SEM)] was higher after 750 mg of lithium [93.1 (1.7) versus 89.5 (1.9 mmHg, P = 0.014], and the subsequent rise in blood pressure during angiotensin II infusion was lower [8.2 (1.8) versus 12.2 (2.4) mmHg, P less than 0.02]. 3. Lithium at a dose of 750 mg increased overnight urinary sodium excretion before the study. The fall in fractional sodium excretion during angiotensin II infusion was reduced after pretreatment with 750 mg of lithium [750 mg of lithium, 2.73 (0.24) to 1.34 (0.08)%; placebo, 2.69 (0.26) to 1.01 (0.11)%; P = 0.02]. The increases in effective filtration fraction [750 mg of lithium, 5.4 (1.0)%; placebo, 8.6 (0.7)%; P less than 0.05] and total effective renal vascular resistance [750 mg of lithium, 3700 (390) dyn s cm-5; placebo 5100 (460) dyn s cm-5; P = 0.03] during angiotensin II infusion were also attenuated after 750 mg of lithium. Responses after 250 mg of lithium did not differ from those after placebo. 4. The fall in plasma renin activity and the increase in plasma aldosterone concentration during angiotensin II infusion were similar on each study day. 5. Renal responses to exogenous angiotensin II are altered after pretreatment with a 750 mg dose of lithium in normal man. This dose of lithium is not an inert marker of sodium handling.

Adult↗
PubMed2003

Relationship between erythrocyte lithium concentration and renal concentrating capacity.

BACKGROUND: Studies investigating possible correlations between plasma lithium concentration, lithium treatment duration, and frequency of lithium administration, and lithium nephrotoxicity have yielded conflicting results. OBJECTIVES: Our main objective was to investigate whether there was any relationship between erythrocyte lithium concentration (ELC) and renal side effects. Another objective of our study was to identify a parameter, which could be estimated inexpensively, for assessing possible renal side-effects of lithium. METHOD: Seventy Iranian inpatients with bipolar disorder entered this case-control study. Medications taken concurrently by the patients were recorded. A direct method of measuring ELC was used in this study. The cases were patients on lithium who had urine specific gravity (SG) of 1.006 or less after 8-10 h water deprivation at night and the controls consisted of patients on lithium with urine SG of 1.011 or more after this period. Blood urea nitrogen, serum creatinine, sodium and potassium and urine SG, sodium, and potassium were measured in all patients during this time. Renal indices were compared by using independent sample t-test at a significance level of a P-value of 0.05 or less. Non-parametric Spearman's rank correlation test was used to investigate the relationship between clinical variables and the indices of renal function. RESULTS: Results revealed that in case group mean serum sodium concentrations were significantly higher (P = 0.008) and mean urine sodium and potassium were significantly lower than those of controls (P = 0.004 and 0.007 respectively). We found no statistically difference in lithium ratios between the two groups. However, ELCs were significantly higher in the cases (P = 0.026). There were no significant correlation between concomitant use of neuroleptics, benzodiazepines or carbamazepine and ELC or lithium renal side-effects. CONCLUSION: This study showed that ELC may reflect lithium renal side-effects better than plasma lithium level.

Adult↗