The efficacy of low-dose lithium: clinical, psychological and biological correlates.
The relationships between lithium dosage, affective morbidity, side-effects, thyroid and renal function and biological markers for depression were examined in the context of a prospective double-blind lithium reduction study in patients receiving prophylactic lithium. Unipolar and bipolar patients on such treatment were randomly allocated to two groups over a period of one year, either continuing with their usual dosage of lithium or reducing their lithium dosage by up to 50%. Biological markers investigated included dexamethasone suppression test (DST) and 5-hydroxytryptamine (5-HT) transport into platelets (Vmax). Results showed no association between affective morbidity and lithium dosage/level. There was, however, an association between lower dosage/level of lithium and lower side-effects, including tremor and weight gain, lower TSH levels and lower 24 h urinary volume in these patients. Elderly patients, however, experienced significantly greater morbidity upon reduction of their lithium dosage. There was an association between increased Vmax of 5-HT transport and a reduction in morbidity. DST non-suppression was associated with lower mean weight for the whole year of the study.
Abou-Saleh
M T
MT
University Department of Psychiatry, Royal Liverpool Hospital.
Coppen
A
A
D000328:Adult; D000368:Aged; D001714:Bipolar Disorder / Q000097:blood / Q000188:drug therapy* / Q000523:psychology; D001792:Blood Platelets / Q000378:metabolism; D002986:Clinical Trials as Topic; D003692:Delayed-Action Preparations; D003907:Dexamethasone; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008094:Lithium / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D016651:Lithium Carbonate; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012701:Serotonin / Q000097:blood
D003692:Delayed-Action Preparations; D016651:Lithium Carbonate; D012701:Serotonin; D003907:Dexamethasone; D008094:Lithium; D006854:Hydrocortisone