Erythrocyte ATP-ase activities were determined in 32 drug-free patients with depression in the course of affective illness, during acute episode, in 24 drug-free patients with schizophrenia, during exacerbation of the illness, and in 25 healthy control subjects. In both depression and schizophrenia, the activities of all three ATP-ases studied (Na-K ATPase, Mg ATPase, Ca-Mg ATPase) were significantly lower than in control subjects. No difference was found between patients with depression in the course of bipolar and unipolar affective illness. In patients with schizophrenia, the activity of Na-K ATPase was lower in the paranoid type of the illness. The results are discussed in the light of contemporary biochemical concepts of major psychoses.

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Previous studies suggested that in patients with affective illness, lithium ion accumulated more in erythrocytes (higher erythrocyte lithium ratio) as well as in the total body (greater lithium retention). The aim of this study was to estimate the relationship between erythrocyte lithium transport mechanisms and the parameters of lithium pharmacokinetics in 11 affective patients during depressive episodes. It was found that the activity of erythrocyte lithium-sodium countertransport (LSC) governing lithium transport out of the erythrocytes, measured in vitro, significantly correlated with rate constant (K21) of lithium transport from intra-to extracellular compartment. Passive lithium diffusion (PLD) in erythrocytes correlated with K21/ K12 ratio. Neither LSC nor PLD correlated with renal lithium clearance. The results show that, in affective patients, the activity of erythrocyte LSC may serve as a model of the intensity of lithium extrusion from cells in the total body.KEY WORDS-Lithium pharmockinetics, erythrocyte lithium-sodium countertransport, affective illness.

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The rehabilitation of patients with longterm psychiatric disorders F Chapireau CCOMS, Centre Paul Broca, 2 ter rue d'Al&a,