Lithium distribution in mania: single-dose pharmacokinetics and sympathoadrenal function.
We examined lithium distribution after a single dose of 25 mEq in 14 drug-free manic patients. Lithium concentrations were measured in plasma, red blood cells, and urine. Maximum concentrations of lithium, times at which they were attained, and influx and efflux rate constants for extracellular fluid, red blood cell, and muscle-like compartments were estimated using a three-compartment pharmacokinetic model. Tissue lithium concentrations may continue to increase for hours after plasma lithium concentrations have peaked. Rate constants for absorption, excretion, and influx and efflux for the tissue compartments were similar to those previously reported for normal subjects. Rate constants for transport into and out of the tissue compartments correlated negatively with norepinephrine or epinephrine excretion and positively with the plasma/red cell Na+ gradient. Rate constants for efflux from red blood cell and muscle compartments correlated with measures of adrenocortical function and were higher in dexamethasone nonsuppressors than in suppressors. These data show that distribution of lithium may be related to sympathodrenal activity and Na+ distribution in manic patients.
Swann
A C
AC
Department of Psychiatry, University of Texas Medical School, Houston 77225.
Berman
N
N
Frazer
A
A
Koslow
S H
SH
Maas
J W
JW
Pandey
G N
GN
Secunda
S
S
D000302:Adrenal Cortex / Q000294:innervation*; D000328:Adult; D001714:Bipolar Disorder / Q000097:blood* / Q000188:drug therapy; D004837:Epinephrine / Q000097:blood; D004912:Erythrocytes / Q000378:metabolism; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008094:Lithium / Q000493:pharmacokinetics* / Q000627:therapeutic use; D016651:Lithium Carbonate; D008297:Male; D008657:Metabolic Clearance Rate / Q000502:physiology; D008875:Middle Aged; D009132:Muscles / Q000378:metabolism; D009638:Norepinephrine / Q000097:blood; D013564:Sympathetic Nervous System / Q000187:drug effects*
D016651:Lithium Carbonate; D008094:Lithium; D006854:Hydrocortisone; D009638:Norepinephrine; D004837:Epinephrine