title: No correlation between lithium serum levels and psychopathological features during the euthymic interval of patients with recurrent affective disorder.
abstract: BACKGROUND
  The aim of this prospective study was to investigate the influence of lithium serum levels on subclinical psychopathological features during the euthymic interval in patients with an affective disorder.
  
  
  METHODS
  The study included 54 patients with a recurrent affective disorder undergoing a continuous prophylactic lithium treatment (31 unipolar, 23 bipolar). The observation period lasted for 2 years and included 332 visits. Visits consisted of a detailed interview, a continuous measurement of lithium levels and the collection of validated scales including HAMD, YMRS, CGI, VAMS and the SCL-90R. Several correlations between lithium serum levels and different psychopathological features during the euthymic interval were calculated on an individual patient basis and on a group basis to reveal generally occurring correlations.
  
  
  RESULTS
  No generally occurring significant correlations between lithium serum levels and specific psychopathological features were found. Only on a single patient level, 32 significant correlations between lithium level and specific psychopathological features were found, partly indicating a negative and partly indicating a positive influence of higher lithium levels on psychopathological symptoms. Nevertheless, in the group analyses no significant correlations were found.
  
  
  CONCLUSIONS
  Higher lithium levels were not associated with an improved psychopathological status, but they were not associated with a worse status (due to a higher burden of side effects) either. According to the literature there is currently no strong evidence to treat patients with a higher lithium level. It is recommended to start with a lower level and to continue with individual adjustments in accordance to prophylactic efficacy and tolerability.
authors: Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Dresden, Germany. ute.lewitzka@uniklinikumdresden.de
authors: U
authors: U
authors: Lewitzka
authors: R
authors: R
authors: Scheffczyk
authors: D
authors: D
authors: Ritter
authors: S
authors: S
authors: Doucette
authors: M
authors: M
authors: Bauer
authors: T
authors: T
authors: Bschor
mesh_terms: D000328:Adult; D000339:Affect / Q000187:drug effects; D000341:Affective Disorders, Psychotic / Q000097:blood* / Q000503:physiopathology / Q000517:prevention & control / Q000523:psychology*; D000368:Aged; D018692:Antimanic Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D016903:Drug Monitoring; D005260:Female; D005858:Germany; D006785:Hospitals, University; D006801:Humans; D008094:Lithium / Q000097:blood*; D018021:Lithium Chloride / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D055502:Secondary Prevention; D055815:Young Adult
chemical_list: D018692:Antimanic Agents; D008094:Lithium; D018021:Lithium Chloride