Twelve-hour brain lithium concentration in lithium maintenance treatment of manic-depressive disorder: daily versus alternate-day dosing schedule.
The 12-h brain lithium concentration was measured by lithium-7 magnetic resonance spectroscopy in ten manic-depressive patients receiving daily or alternate-day lithium carbonate treatment. The median dose of lithium carbonate was 800 mg in the daily treatment group and 1200 mg in the alternate-day group. Median 12-h serum lithium concentration in the two groups was 0.86 mmol l-1 and 0.55 mmol l-1, respectively, while the corresponding concentration in brain was 0.67 mmol l-1 and 0.52 mmol l-1, respectively. The 12-h brain lithium concentration was independent of lithium dosing schedule (multiple linear regression), but correlated significantly with the 12-h serum lithium concentration (P = 0.003; B = 0.53, 95% c.l. 0.24-0.82; beta = 0.83). Thus at identical 12-h serum lithium concentrations the 12-h brain lithium concentration is similar with both treatment regimes. As the risk of manic-depressive relapse during alternate-day lithium treatment is in our experience 3-fold greater than with daily treatment (at similar mean 12-h serum lithium concentration), the findings suggest that the difference in the prophylactic efficacy of the two dosing schedules is unrelated to differences in the 12-h brain lithium concentration.
Jensen
H V
HV
Psychiatry Department, Rigshospitalet, Copenhagen, Denmark.
Plenge
P
P
Stensgaard
A
A
Mellerup
E T
ET
Thomsen
C
C
Aggernaes
H
H
Henriksen
O
O
D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000008:administration & dosage*; D018692:Antimanic Agents / Q000008:administration & dosage*; D001714:Bipolar Disorder / Q000188:drug therapy*; D001921:Brain / Q000378:metabolism*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008094:Lithium / Q000032:analysis; D016651:Lithium Carbonate / Q000008:administration & dosage*; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged
D000928:Antidepressive Agents; D018692:Antimanic Agents; D016651:Lithium Carbonate; D008094:Lithium