engleski

Monitoring of lithium therapy for manic depression

Lithium has been demonstrated to be therapy of choice in the treatement and prevention of mania and manic depression. The narrow therapeutic range (0.5-1.2 mmol/L) and significant side effects are associated with lithium require continous control of the drug serum level. Fasting serum concentrations of lithium was determined in 160 patients (95 women and 65 men) treated at the University Department of Psychiatry, Sestre milosrdnice University Hospital, who received 300, 600 or 900 mg lithium per day. Serum lithium concentration was determined by the colorimetric method based on the sample lithium binding to azo dye 6-dodecyl-6-(2 ; ; -hydroxy-5 ; ; -(2 ; ;  ; ; -4 ; ;  ; ; -dinitrophenylazo)benzyl-13, 13-dimethyl-1, 4, 6, 11-tetraoxacyclotetradecane (Vitros Li slidesi, Ortho-Clinical Diagnostics, a Johnson-Johnson company, Kodak Ektachem analyzer). In the women receiving 300 (n=7), 600 (n=40) and 900 (n=48) mg lithium/day, the mean (range) serum lithium concentration was 0.39 (0.24-0.59), 0.60 (0.25-1.17) and 0.68 (0.24-1.17) mmol/L, respectively. Among men, none of the patients received a dose of 300 mg lithium/day. In the men administered 600 (n=23) and 900 (n=40) mg lithium/day, the mean (range) serum lithium concentration was 0.51 (0.26-0.99) and 0.65 (0.2-1.48) mmol/L rspectively. These results clearly point to the need of therapeutic monitoring, for both serious lithium side effects within therapeutic range and to the patient's thepapeutic compliance.

lithium therapy; manic depression

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