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[Labial herpes in patients with affective disorders receiving long-term lithium carbonate].

Lithium carbonate has been administered to 69 patients (45 women and 24 men) for 1-17 years as affective disorders prevention. Its effect on the recurrence and clinical course of labial herpes infection has been analysed both prior to and after the administration of lithium carbonate. Labial herpes has been diagnosed in 28 patients before lithium prophylaxis. The drug significantly decreased virus infection recurrence incidence in this group. No labial herpes recurrence has been noted in 13 patients after the treatment. Lithium efficiency has not been dependent on patients' age, duration of therapy, and lithium levels in both blood serum and erythrocytes. These results suggest, that lithium salts may be effective in certain herpes simplex infections at doses used for prevention affective disorders.

Adult↗

Kinematics of fast wrist movements in manic-depressive illness chronically treated with lithium carbonate.

Lithium salts have been shown to impair kinematics of fast voluntary movements during acute intoxication. The aim of the present study was to determine whether lithium carbonate affected the kinematics of fast movements in patients chronically treated and who did not exhibit signs of neurotoxicity. We analysed fast wrist flexion movements in 6 healthy subjects, in 5 patients presenting a manic-depressive illness without treatment, and in 8 patients receiving lithium carbonate for a manic-depressive disease. The mean duration of treatment was 3.9 +/- 4.1 years, the mean daily dose 837 +/- 341 mg and the mean serum level 0.95 +/- 0.15 mEq/l. Although mean movement amplitudes were similar in the 3 groups, the variability of fast movements was increased in patients receiving lithium salts. The ratio of maximum to average velocities (Vm/Vave) was significantly higher in patients treated, and their movements were temporally asymmetrical, with a ratio of acceleration duration divided by deceleration duration being lower than in the 2 other groups. These kinematic abnormalities show that a chronic treatment with lithium salts is associated with an impairment of the cerebellar control of fast single-joint movements.

Acceleration↗

[The possibility of replacing blood serum with sputum for monitoring of therapy with lithium carbonate].

Lithium concentration was determined in both sputum and blood serum of 31 patients treated with lithium carbonate. It was found that lithium concentration rate in the sputum/blood serum is 2.17 +/- 0.16, and is constant in all patients, except one, for a long time. A high correlation index between lithium concentration in the sputum and blood serum (r = 0.9025, and without two assays in the above mentioned patient r = 0.9858) as well as stability of sputum/serum lithium levels enable -- in the opinion of the authors -- to control lithium concentration in the body, using sputum for the assays. These assays are easy to perform with the aid of the kit called "Salivette" (Sarstedt, Germany). Its principle was discussed, too.

Female↗

Focal segmental glomerulosclerosis in patients receiving lithium carbonate.

Lithium carbonate is a commonly used psychiatric medication with a number of toxic renal effects, which include nephrotic-range proteinuria. A review of the literature concerning lithium-induced proteinuria is presented and three cases of nephrotic-range proteinuria are described in association with lithium therapy. The pathology in these three cases was focal segmental glomerulosclerosis, a finding not previously described.

Adult↗

Bioavailability of lithium carbonate and lithium citrate: a comparison of two controlled-release preparations.

The pharmacokinetics of two marketed controlled-release lithium preparations, lithium carbonate ('Priadel') and lithium citrate ('Litarex'), were compared in 5 normal volunteers in a crossover design using identical doses (27.2 mmol lithium). Although the total bioavailability of the two preparations was similar, the peak serum lithium achieved was significantly lower with the lithium citrate than with the lithium carbonate preparation.

Adult↗

Treatment of the syndrome of inappropriate secretion of antidiuretic hormone with lithium carbonate.

Lithium, an established inhibitor of antidiuretic hormone action, was used (as the carbonate salt) to treat a patient with the syndrome of inappropriate secreation of antidiuretic hormone. The patient was studied by balance technics, and after a stablized hyponatremic state developed, 0.9 g of lithium carbonate was administered daily. A prompt water diuresis ensued, with correctionof hyponatremia in two days. Discontinuation of the drug resulted in a gradual return of the hyponatremic state. No change in urinary cyclic AMP occurred during the period of lithium effect. Lithium carbonate may be an effective treatment for both the acute and the chronic forms of the syndrome.

Administration, Oral↗

[Dose-effect relation in therapy of cytostatic-induced leukopenia with lithium carbonate].

Lithium is used increasingly for attenuation of chemotherapy induced leukopenia in infants and adolescents. Thus, pharmacological data are needed. The purpose of this study was to give recommendations for oral dosage yielding efficient serum levels. Furthermore, two methods of serum level determination were compared. Flame emission photometry using microsamples gave results comparable to atomic absorption photometry. The correlation of oral dose and serum level was investigated in a phase I study. A wide range of serum levels related to an identical oral dose was found. Therefore, frequent serum level determinations are needed to realize efficacy and to avoid toxicity. The correlation between increasing serum levels and leucocyte count was investigated in the first part of a phase II study. No significance was found; i.e. a linear progressing dose-effect relation does not exist. The time course of leukocyte count was analysed for two different serum level groups in the second part of the phase II study. A significant correlation was found in the group with a serum level greater 0,7 mmol/l.

Adult↗

Drug therapy in the prevention of recurrences in unipolar and bipolar affective disorders. Report of the NIMH Collaborative Study Group comparing lithium carbonate, imipramine, and a lithium carbonate-imipramine combination.

In a double-blind, long-term follow-up study, 117 bipolar patients received lithium carbonate, imipramine hydrochloride, or both and 150 unipolar patients received lithium carbonate, imipramine, both lithium carbonate and imipramine, or placebo. With bipolar patients, lithium carbonate and the combination treatment were superior to imipramine in preventing manic recurrences and were as effective as imipramine in preventing manic recurrences and were as effective as imipramine in preventing depressive episodes. The combination treatment provided no advantage over lithium carbonate alone. With unipolar patients, imipramine and the combination treatment were more effective than lithium carbonate and placebo in preventing depressive recurrences. The combination treatment provided no advantage over imipramine alone. The lithium carbonate-treated group had fewer manic episodes than the other groups. Treatment outcome, which was evaluated primarily in terms of the occurrence of major depression or manic episodes, was significantly related to characteristics of the index episode, ie, the episode that brought the patient into the study.

Actuarial Analysis↗

Comparison of side effects with coated lithium carbonate tablets and lithium sulphate preparations giving medium-slow and slow-release.

Side effects with coated, rapidly dissolving lithium carbonate tablets, medium-slow-release and slow release lithium sulphate tablets, all administered twice a day, were compared in a double-blind, cross-over study in 27 patients who had only used lithium carbonate tablets. The relation between medication and meals was not standardized. The repidly dissolving tablets and the medium-slow-release tablets had a similar tendency to produce side effects, while slow-release tablets more often produced purgative side effects than the other two preparations did.

Adult↗

Lithium carbonate in chronic schizophrenia--a brief trial of lithium carbonate added to neuroleptics for treatment of resistant schizophrenic patients.

The value of lithium carbonate as an adjunctive treatment of resistant schizophrenia was tested in a 4-week clinical trial using a single-blind, randomized, consent design. Treatment and control groups were drawn from a population of detained patients in an English special (maximum security) hospital. The 2 groups were comparable in terms of age, sex, severity of symptoms, length of hospitalization and concurrent neuroleptic dosage. The addition of lithium carbonate to the treatment regimen did not result in symptomatic improvement in patients completing the treatment protocol. The ethical and practical difficulties raised by the trial are discussed.

Adult↗

Severe sodium depletion syndrome during lithium carbonate therapy.

Lithium carbonate, useful in the treatment of manic-depressive disorders, can produce nephrogenic diabetes insipidus. The drug, therefore, has been used to facilitate renal waster excretion when severe hyponatremia occurs in the syndrome of inappropriate antidiuretic hormone secretion. Symptomatic dilutional hyponatremia developed in a patient with pulmonary carcinoma whom we treated. Lithium carbonate was administered and renal sodium wasting, hypovolemia, and hypotension occurred. Hyperkalemia was also observed, and since adrenal steroid levels were not decreased, impairment of distal tubular function was suggested. Lithium carbonate blocks antidiuretic hormone effect by decreasing collecting duct cyclic adenosine monophosphate generation. These observations suggest that more generalized inhibitory effects on renal tubular function may also result from its use. An alternative drug, demeclocycline, may be preferable.

Carcinoma, Squamous Cell↗

Comparing oral lithium carbonate and intraperitoneal lithium chloride chronic administrations on rats' activity levels.

This study compares the effects produced by two modalities of lithium administration on rats' activity levels. Lithium was administered for 21 days either as carbonate in the diet (2 g in 2 liters of water and 1,500 g lab chow) or as chloride through single daily intraperitoneal injections (1 mEq/kg LiCl). Both treatments resulted in similar decreases in spontaneous activity and exploratory behavior, as recorded in an open field with a hole-board. Neither treatment influenced the amount of food consumed on a daily basis nor the rate of growth as manifested by weight gains over the period considered, suggesting that these treatments were not adversely affecting the animals' health. Both treatments increased water intake over control levels, this effect being most marked with the diet lithium carbonate administration, particularly during the second week of treatment. This latter modality of lithium administration, but not the injections of lithium chloride, significantly increased NaCl intake over control levels.

Administration, Oral↗

[The effect of lithium carbonate on the leukocyte count following ionizing radiation. 4. The effect of lithium carbonate on the activation of granulocytes].

From numerous investigations it is known that lithium carbonate promotes granulocytopoiesis by stimulation of CSF (colony stimulating factor) in bone marrow. To prove if no immature, in their functions restricted cells are delivered from bone marrow, the activity of granulocytes was tested in vitro in patients with lithium therapy. It could be seen that granulocytes of peripheral blood show an increased in-vitro-activation after lithium influence in vivo.

Dysgerminoma↗

Lithium carbonate and brain function. I. Cerebral-evoked potentials, EEG, and symptom changes during lithium carbonate treatment.

Eighteen patients were studied with behavioral ratings and the somatosensory (SER), auditory (AER), and visual (VER) cerebral-evoked response and quantified EEG before and during lithium carbonate treatment. The amplitude of early positive SER components and most AER components increased during treatment, but VER did not change. The intensity of EEG delta and theta frequencies increased, and the dominant alpha frequency slowed. Before treatment, there were few significant correlations to symptom intensity. Patients with an increase in symptoms on treatment had the greatest increase in EEG delta intensity and the dominant alpha frequency slowed in patients who became more depressed. The EEG slowing in patients with a normal sensorium and the change in cerebral cortical activity after transmission in the somatosensory pathway over just three synapses demonstrate a unique and specific effect of lithium carbonate on brain function.

Adult↗

Lipid peroxidation as a possible mechanism for the neurotoxic and nephrotoxic effects of a combination of lithium carbonate and haloperidol.

Lithium carbonate as well as haloperidol increased lipid peroxidation in rat cerebral cortex synaptosomes and rat kidney homogenates while sulpiride had no significant effects. A combination of lithium carbonate and haloperidol caused a greater increase in lipid peroxidation than did either lithium carbonate or haloperidol alone. It is concluded that the neurotoxic and nephrotoxic effects of lithium carbonate and haloperidol might be a consequence of increased lipid peroxidation in the cerebral cortex and the kidney, respectively.

Animals↗