Decreasing lithium dosage reduces morbidity and side-effects during prophylaxis

Coppen, Alec; Abou-Saleh, M T; Milln, P; Bailey, John E.; Wood, Keith

doi:10.1016/0165-0327(83)90026-5

Cited by 77 publications

(55 citation statements)

References 10 publications

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“…In our lithium carbonate dosage reduction study (17) we found that the plasma concentration of TSH was significantly lower in patients with a plasma lithium level <0.79 mmol/l (mean 5.6 f 1.1 uU/ml) than in patients with a plasma lithium level B0.80 mmol/l (mean 9.8 f 3.1 uU/ml; P<O.OS).…”

Section: Lithium Dosagementioning

confidence: 67%

“…More recently we have examined the question of dosage in terms of the 12-h plasma levels. We found that using a once daily dosage regimen to give a plasma level of between 0.45 and 0.79 mmol/l was significantly better than the conventional level of 0.8 -1.2 mmol/l (17). This is probably because the lower plasma levels do not interfere with thyroid function (18).…”

mentioning

confidence: 94%

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Lithium therapy: from clinical trials to practical management

Coppen

Abou-Saleh

1988

Acta Psychiatr Scand

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Controlled trials have shown that lithium significantly reduces the morbidity of recurrent affective disorders. We describe here the ongoing affective morbidity in unipolar, bipolar and schizoaffective illness treated primarily by low dosage, once daily lithium, supplemented as necessary by antidepressant or neuroleptic medication. Seventy-eight percent of unipolar patients and 73% of bipolar and schizoaffective patients had no or only slight morbidity during the study year. The treatment was equally effective for both older (age greater than 70 years) and younger patients. Unipolar patients rated as endogenous on the Newcastle Scale had significantly lower morbidity than the nonendogenous patients. Subjective side effects were minimal. These patients, whose untreated morbidity is known to be high, derive considerable benefit from regular supervision in an affective disorder clinic.

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Section: Lithium Dosagementioning

confidence: 67%

mentioning

confidence: 94%

Lithium therapy: from clinical trials to practical management

Coppen

Abou-Saleh

1988

Acta Psychiatr Scand

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“…If environmental stress exposure is linked to illness onset, especially during key developmental periods (Walker et al, 2001(Walker et al, , 2010, then central nervous system (CNS) HPA-axis dysfunction should be present in schizophrenia. In support of this HPA-axis dysfunction, for over 30 years, researchers have identified high concentrations of cortisol present in schizophrenia samples (Coppen et al, 1983;Tandon et al, 1991;Walker et al, 2013). These findings, coupled with documented evidence of diminished hippocampal volume, further highlight the mediating role of the HPAaxis functioning between environmental stressors and psychiatric illness (Stansbury and Gunnar, 1994;Walker and Diforio, 1997).…”

Section: Stress Sensitivity and The Hpa-axismentioning

confidence: 88%

Heart rate variability and vagal tone in schizophrenia: A review

Montaquila

Trachik

Bedwell

2015

Journal of Psychiatric Research

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“…It was not until the pharmacokinetics of lithium became the foundation of standardized serum lithium for the monitoring of treatment, 21 and the irreversibility of lithium nephropathy became common knowledge 3 that scientifically based safety routines gradually developed. They included lower and individualized serum lithium levels 22,23 resulting eventually in the average 0.59 mmol/l serum lithium level of our current lithium-treated population.…”

Section: Discussionmentioning

confidence: 98%

Renal failure occurs in chronic lithium treatment but is uncommon

Bendz

Schön

Attman

et al. 2010

Kidney International

164

135

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We sought to establish the prevalence of lithium-induced end-stage renal disease in two regions of Sweden with 2.7 million inhabitants corresponding to about 30% of the Swedish population. Eighteen patients with lithium-induced end-stage renal disease were identified among the 3369 patients in the general lithium-treated population, representing a sixfold increase in prevalence compared with the general population for renal replacement therapy. All lithium-treated patients were older than 46 years at end-stage renal disease with a mean lithium treatment time of 23 years with ten patients having discontinued lithium treatment an average of 10 years before the start of renal replacement therapy. The prevalence of chronic kidney disease (defined as plasma creatinine over 150 micromol/l) in the general lithium-treated population was about 1.2% (excluding patients on renal replacement therapy). Compared with lithium-treated patients without renal failure, those with chronic kidney disease were older and most were men but, as groups, their mean serum lithium levels and psychiatric diagnoses did not differ. We found that end-stage renal disease is an uncommon but not rare consequence of long-term lithium treatment and is more prevalent than previously thought. Time on lithium was the only identified risk factor in this study, suggesting that regular monitoring of renal function in these patients is mandatory.

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Decreasing lithium dosage reduces morbidity and side-effects during prophylaxis

Cited by 77 publications

References 10 publications

Lithium therapy: from clinical trials to practical management

Lithium therapy: from clinical trials to practical management

Heart rate variability and vagal tone in schizophrenia: A review

Renal failure occurs in chronic lithium treatment but is uncommon

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