Lithium distribution in mania: Plasma and red blood cell lithium, clinical state, and monoamine metabolites during lithium treatment

Alan C. Swann, Nancy Berman, Alan Frazer, Stephen H. Koslow, Steven Secunda

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

We examined red blood cell (RBC) and plasma lithium concentrations and RBC/plasma lithium ratios in 14 manic patients during lithium treatment as part of the National Institute of Mental Health's Collaborative Program on the Psychobiology of Depression, Biological Studies. All of the lithium measures increased during treament, especially RBC lithium. There were positive correlations between the RBC lithium concentration and the RBC/plasma lithium ratio and their maximal values in a single-dose pharmacokinetic experiment before treatment. After 5 and 16 days of treatment, patients with good subsequent outcome had higher RBC/plasma lithium ratios than did patients with poor outcome. Early in treatment, there was a negative correlation between lithium concentrations and severity of mania. During treatment, there was a negative correlation between RBC lithium and urinary MHPG excretion. There was a positive correlation between RBC or plasma lithium during the first few days of treatment and subsequent reduction in norepinephrine excertion during treatment. At 3 weeks, there were negative correlations between reductions in catecholamine measures and lithium concentrations. These data suggest that there are changes in the sensitivity of behavior and catecholamine function to lithium during treatment. RBC concentrations of lithium appear to be a potentially useful indicator of its behavioral and neurochemical effects.

Original languageEnglish (US)
Pages (from-to)1-12
Number of pages12
JournalPsychiatry Research
Volume20
Issue number1
DOIs
StatePublished - Jan 1987
Externally publishedYes

Keywords

  • Mania
  • catecholamines
  • lithium distribution
  • lithium treatment

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

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