Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-23T07:05:32.510Z Has data issue: false hasContentIssue false

Case 9: Too much, too little, or just right? Lithium dosing in an adolescent

Published online by Cambridge University Press:  09 February 2024

Jeffrey R. Strawn  and
Stephen M. Stahl
Jeffrey R. Strawn
Affiliation:
University of Cincinnati, Ohio
Stephen M. Stahl
Affiliation:
University of California, San Diego
Get access

Summary

Compared to adults, young adolescents treated with lithium may require higher mg/kg doses because of:

Type
Chapter
Information
Case Studies: Stahl's Essential Psychopharmacology
Children and Adolescents
 , pp. 137 - 154
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Birmaher, B., Axelson, D., Goldstein, B., et al. Four-year longitudinal course of children and adolescents with bipolar spectrum disorders: the course and outcome of bipolar youth (COBY) study. Am J Psychiatry 2009; 166(7): 795–804. https://doi.org/10.1176/appi.ajp.2009.08101569Google Scholar
Castro, V. M., Roberson, A. M., McCoy, T. H., et al. Stratifying risk for renal insufficiency among lithium-treated patients: an electronic health record study. Neuropsychopharmacology 2016; 41(4): 1138–43. https://doi.org/10.1038/npp.2015.254Google Scholar
Clos, S., Rauchhaus, P., Severn, A., Cochrane, L., Donnan, P. T. Long-term effect of lithium maintenance therapy on estimated glomerular filtration rate in patients with affective disorders: a population-based cohort study. Lancet Psychiatry 2015; 2(12): 1075–83. https://doi.org/10.1016/S2215-0366(15)00316-8Google Scholar
Correll, C. U., Sheridan, E. M., DelBello, M. P. Antipsychotic and mood stabilizer efficacy and tolerability in pediatric and adult patients with bipolar I mania: a comparative analysis of acute, randomized, placebo-controlled trials. Bipolar Disord 2010; 12(2): 166–41. https://doi.org/10.1111/j.1399-5618.2010.00798.xGoogle Scholar
DelBello, M. P., Hanseman, D., Adler, C. M., Fleck, D. E., Strakowski, S. M. Twelve-month outcome of adolescents with bipolar disorder following first hospitalization for a manic or mixed episode. Am J Psychiatry 2007; 164(4): 582–90. https://doi.org/10.1176/ajp.2007.164.4.582Google Scholar
Findling, R. L., Frazier, J. A., Kafantaris, V., et al. The Collaborative Lithium Trials (CoLT): specific aims, methods, and implementation. Child Adolesc Psychiatry Mental Health 2008; 2: 21. https://doi.org/10.1186/1753-2000-2-21Google Scholar
Findling, R. L., Kafantaris, V., Pavuluri, M., et al. Dosing strategies for lithium monotherapy in children and adolescents with bipolar I disorder. J Child Adolesc Psychopharmacol 2011; 21(3): 195–205. https://doi.org/10.1089/cap.2010.0084Google Scholar
Findling, R. L., Landersdorfer, C. B., Kafantaris, , V., et al. First-dose pharmacokinetics of lithium carbonate in children and adolescents. J Clin Psychopharmacol 2010; 30(4): 404–10. https://doi.org/10.1097/JCP.0b013e3181e66a62Google Scholar
Findling, R. L., McNamara, N. K., Pavuluri, M., et al. Lithium for the maintenance treatment of bipolar I disorder: a double-blind, placebo-controlled discontinuation study. J Am Acad Child Adolesc Psychiatry 2019; 58(2): 287–96. https://doi.org/10.1016/j.jaac.2018.07.901Google Scholar
Findling, R. L., Robb, A., McNamara, N. K. Lithium in the acute treatment of bipolar I disorder: a double-blind, placebo-controlled study. Pediatrics 2015; 136(5): 885–94. https://doi.org/10.1542/peds.2015-0743Google Scholar
Heald, A. H., Holland, D., Stedman, M., et al. Can we check serum lithium levels less often without compromising patient safety? BJPsych Open 2021; 8: e18. https://doi.org10.1192/bjo.2021.1027Google Scholar
Hunt, J. I., Case, B. G., Birmaher, B., et al. Irritability and elation in a large bipolar youth sample: relative symptom severity and clinical outcomes over 4 years. J Clin Psychiatry 2013; 74(1): e110–17. https://doi.org/10.4088/JCP.12m07874Google Scholar
Kirkham, E., Skinner, J., Anderson, T., et al. One lithium level >1.0 mmol/L causes an acute decline in eGFR: findings from a retrospective analysis of a monitoring database. BMJ Open 2014; 4: e006020. https://doi.org/10.1136/bmjopen-2014-006020Google Scholar
Landersdorfer, C. B., Findling, R. L., Frazier, J. A., Kafantaris, V., Kirkpatrick, C. M. J. Lithium in paediatric patients with bipolar disorder: implications for selection of dosage regimens via population pharmacokinetics/pharmacodynamics. Clinical Pharmacokinetics 2017; 56(1): 77–90. https://doi.org/10.1007/s40262-016-0430-3Google Scholar
Meyer, J. M., Stahl, S. M. The Lithium Handbook. Cambridge, UK: Cambridge University Press, 2023.Google Scholar
Solmi, M., Radua, J., Olivola, M., et al. Age at onset of mental disorders worldwide: large-scale meta-analysis of 192 epidemiological studies. Mol Psychiatry 2022; 27(1): 281–95. https://doi.org/10.1038/s41380-021-01161-7Google Scholar
van Meter, A. R., Burke, C., Kowatch, R. A., Findling, R. L., Youngstrom, E. A. Ten-year updated meta-analysis of the clinical characteristics of pediatric mania and hypomania. Bipolar Disord 2016; 18(1): 19–32. https://doi.org/10.1111/bdi.12358Google Scholar
Yen, S., Stout, R., Hower, H., et al. The influence of comorbid disorders on the episodicity of bipolar disorder in youth. Acta Psychiatr Scand 2016; 133(4): 324–34. https://doi.org/10.1111/acps.12514Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×