title: Is polarity of recurrence related to serum lithium level in patients with bipolar disorder?
abstract: BACKGROUND
  Recently published data might indicate that the polarity of recurrence is related to lithium serum levels. To systematically test this hypothesis all published maintenance trials in bipolar disorders were examined with regard to this issue.
  
  
  METHODS
  Maintenance studies were subdivided in trials with low (i. e. below 0.6 mEq/l),medium (i. e. 0.6 to 0.8 mEq/l) and high (i. e. above 0.8 mEq/l) lithium serum levels. Percentage of depressive vs. (hypo-)manic or mixed recurrences were compared for these three groups.
  
  
  RESULTS
  The percentage of depressive recurrences in the groups with low, medium and high lithium levels differed in a clinically and statistically significant manner (12% vs. 38% vs. 64%, p < 0.0001).
  
  
  CONCLUSIONS
  The results might indicate that low lithium levels are effective in preventing depression whereas higher blood levels are needed to prevent (hypo-)manic or mixed states.
authors.affiliation: Psychiatric Hospital of the University of Munich, Nussbaumstr. 7, 80336 Munich, Germany. nikolaus.kleindienst@med.uni-muenchen.de
authors.forename: N
authors.initials: N
authors.lastname: Kleindienst
authors.forename: W E
authors.initials: WE
authors.lastname: Severus
authors.forename: H-J
authors.initials: HJ
authors.lastname: Möller
authors.forename: W
authors.initials: W
authors.lastname: Greil
mesh_terms: D001714:Bipolar Disorder / Q000097:blood* / Q000517:prevention & control*; D016009:Chi-Square Distribution; D004305:Dose-Response Relationship, Drug; D006801:Humans; D008094:Lithium / Q000097:blood* / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D055502:Secondary Prevention
chemical_list: D008094:Lithium