Risk factors for the development of lithium-induced polyuria.
BACKGROUND
Polyuria is common in patients with bipolar disorder treated with lithium. However, the risk factors for polyuria in these patients have not been established.


OBJECTIVE
To estimate the prevalence of polyuria associated with the use of lithium and to identify additional risk factors.


METHODS
A 4-month prospective follow-up study in an out-patient lithium clinic. The 75 participants were asked to provide 24-h urine samples; polyuria was defined as a urine volume greater than 3 litres per 24 h. Risk factors examined included demographic variables, medications and medical comorbidities.


RESULTS
The prevalence of polyuria among lithium users was 37%. Concomitant use of serotonergic antidepressants was strongly associated with polyuria (odds ratio 4.25, 95% CI 1.15-15.68) compared with patients not using these agents.


CONCLUSIONS
Our data confirm the high prevalence of lithium-induced polyuria. Physicians should be aware that concurrent use of serotonergic antidepressants and lithium significantly enhances the risk of its occurrence. Although limited polyuria is not harmful, it may be troublesome for the patient. In many cases cessation of lithium therapy is not an option because of difficulty in controlling the manic or depressive symptoms.
Movig
K L L
KL
Hospital Pharmacy Midden-Brabant, Tilburg, The Netherlands.
Baumgarten
R
R
Leufkens
H G M
HG
van Laarhoven
J H M
JH
Egberts
A C G
AC
D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000009:adverse effects*; D001714:Bipolar Disorder / Q000188:drug therapy; D003866:Depressive Disorder / Q000188:drug therapy; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008094:Lithium / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011141:Polyuria / Q000139:chemically induced*; D011446:Prospective Studies; D012307:Risk Factors; D018490:Serotonin Agents / Q000627:therapeutic use; D016896:Treatment Outcome
D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D018490:Serotonin Agents; D008094:Lithium