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The effects of administering lithium carbonate on the balance of Na, K and water in manic-depressive patients

Published online by Cambridge University Press:  09 July 2009

Brij M. Saran
Affiliation:
Metabolic Unit, Maudsley Hospital, London
Gerald F. M. Russell*
Affiliation:
Metabolic Unit, Maudsley Hospital, London
*
2Address for correspondence: Professor G. F. M. Russell, Royal Free Hospital, Pond Street, London

Synopsis

Eleven patients in remission from manic-depressive illness were studied by means of metabolic balances before and after the administration of lithium carbonate. Lithium caused a sharp diuresis of isotonic saline and a smaller excretion of potassium over the course of two days. During the subsequent two days there occurred a compensatory retention of Na, K and water. These short-term changes were not associated with any significant alteration in the patients' mood. There was no significant and systematic retention of Na, K or water over the 14 days of Li administration. The recovery of Li was measured simultaneously. During the first week only a proportion of the administered Li was recovered in the urine and faeces, suggesting that a gradual distribution of Li throughout its body space was occurring. After the first week, nearly all the administered Li was recovered, indicating an equilibrium with an even distribution of the ion throughout its body space. This equilibrium was more complete at this early stage in those patients who had been given a smaller dose of lithium carbonate.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1976

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References

REFERENCES

Almy, G. L. & Taylor, M. A. (1973). Lithium retention in mania. Archives of General Psychiatry 29, 232234.CrossRefGoogle ScholarPubMed
Angst, J., Weis, P., Grof, P., Baastrup, P. C. & Schou, M. (1970). Lithium prophylaxis in recurrent affective disorders. British Journal of Psychiatry 116, 604614.CrossRefGoogle ScholarPubMed
Aronoff, M.S., Evens, R. G. & Durell, J. (1971). Effect of lithium salts on electrolyte metabolism. Journal of Psychiatric Research 8, 139159.CrossRefGoogle ScholarPubMed
Baastrup, P. C. (1964). The use of lithium in manic-depressive psychosis. Comprehensive Psychiatry 5, 396408.CrossRefGoogle ScholarPubMed
Baastrup, P. C. & Schou, M. (1967). Lithium as a prophylactic agent. Archives of General Psychiatry 16, 162172.CrossRefGoogle Scholar
Baastrup, P. C., Poulsen, J. C., Schou, M., Thomsen, K. & Amdisen, A. (1970). Prophylactic lithium: Double blind discontinuation in manic-depressive and recurrent depressive disorders. Lancet ii, 326330.CrossRefGoogle Scholar
Baer, L., Durell, J., Bunney, W. E., Levy, B. S., Murphy, D. L., Greenspan, K. & Cardon, P. V. (1970a). Sodium balance and distribution in lithium carbonate therapy. Archives of General Psychiatry 22, 4044.CrossRefGoogle ScholarPubMed
Baer, L., Platman, S. R. & Fieve, R. R. (1970b). The role of electrolytes in affective disorders. Archives of General Psychiatry 22, 108113.CrossRefGoogle ScholarPubMed
Baer, L., Glassman, A. H. & Kassir, S. (1973). Negative sodium balance in lithium carbonate toxicity – evidence of mineralocorticoid blockade. Archives of General Psychiatry 29, 823827.CrossRefGoogle ScholarPubMed
Bunney, W. E., Goodwin, F. K., Davis, J. M. & Fawcett, J. A. (1968). A behavioural-biochemical study of lithium treatment. American Journal of Psychiatry 125, 499512.CrossRefGoogle Scholar
Cade, J. F. J. (1949). Lithium salts in the treatment of psychotic excitement. Medical Journal of Australia 36, 349352.CrossRefGoogle Scholar
Coppen, A. & Shaw, D. M. (1963). Mineral metabolism in melancholia. British Medical Journal 2, 14391444.CrossRefGoogle ScholarPubMed
Coppen, A. & Shaw, D. M. (1967). The distribution of electrolytes and water in patients after taking lithium carbonate. Lancet ii, 805806.CrossRefGoogle Scholar
Coppen, A., Malleson, A. & Shaw, D. M. (1965). Effects of lithium carbonate on electrolyte distribution in man. Lancet i, 682683.CrossRefGoogle Scholar
Coppen, A., Shaw, D. M., Malleson, A. & Costain, R. (1966). Mineral metabolism in mania. British Medical Journal 1, 7175.CrossRefGoogle ScholarPubMed
Coppen, A., Noguera, R., Bailey, J., Burns, B. H., Swani, M. S., Hare, E. H., Gardner, R. & Maggs, R. (1971). Prophylactic lithium in affective disorders: controlled trial. Lancet ii, 275279.CrossRefGoogle Scholar
Epstein, R., Grant, L., Herjanic, M. & Winokur, G. (1965). Urinary excretion of lithium in mania. Journal of the American Medical Association 192, 409.CrossRefGoogle ScholarPubMed
Gershon, S. & Yuwiler, A. (1960). Lithium ion: a specific psychopharmacological approach to the treatment of mania. Journal of Neuropsychiatry 1, 229241.Google Scholar
Goldberg, D. P., Cooper, B., Eastwood, M. R., Kedward, H. B. & Shepherd, M. (1970). A standardized psychiatric interview for use in community surveys. British Journal of Preventive and Social Medicine 24, 1823.Google ScholarPubMed
Greenspan, K., Goodwin, F. K., Bunney, W. E. & Durell, J. (1968). Lithium ion retention and distribution. Archives of General Psychiatry 19, 664673.CrossRefGoogle ScholarPubMed
Hartigan, G. P. (1963). The use of lithium salts in affective disorders. British Journal of Psychiatry 109, 810814.CrossRefGoogle ScholarPubMed
Hullin, R. P., Swinscoe, J. C., McDonald, R. & Dransfield, G. A. (1968). Metabolic balance studies on the effect of lithium salts in manic-depressive psychosis. British Journal of Psychiatry 114, 15611573.Google ScholarPubMed
Johnson, G., Gershon, S. & Hekimian, L. J. (1968). Controlled evaluation of lithium and chlorpromazine in the treatment of manic states: an interim report. Comprehensive Psychiatry 9, 563573.CrossRefGoogle ScholarPubMed
McCance, R. A. & Widdowson, E. M. (1960). The Composition of Foods. MRC Special Report Series No. 297. HMSO: London.Google Scholar
Maggs, R. (1963). Treatment of manic illness with lithium carbonate. British Journal of Psychiatry 109, 5665.CrossRefGoogle Scholar
Mangoni, A., Andreoli, V., Cabibbe, F. & Mandelli, V. (1970). Body fluid distribution in manic and depressed patients treated with lithium carbonate. Acta Psychiatrica Scandinavica 46, 244257.CrossRefGoogle ScholarPubMed
Murphy, D. L., Goodwin, F. K. & Bunney, W. E. Jr (1969). Aldosterone and sodium response to lithium administration in man. Lancet ii, 458461.CrossRefGoogle Scholar
Platman, S. R. & Fieve, R. R. (1969). Lithium retention and excretion. Archives of General Psychiatry 20, 285289.CrossRefGoogle ScholarPubMed
Prien, R. F., Klett, C. J. & Caffey, E. M. (1974). Lithium prophylaxis in recurrent affective illness. American Journal of Psychiatry 131, 198203.CrossRefGoogle ScholarPubMed
Reifenstein, E. C., Albright, F. & Wells, S. L. (1945). The accumulation, interpretation and presentation of data pertaining to metabolic balances, notably those of calcium, phosphorus and nitrogen. Journal of Clinical Endocrinology 5, 367395.CrossRefGoogle ScholarPubMed
Russell, G. F. M. (1967). The nutritional disorder in anorexia nervosa. Journal of Psychosomatic Research 11, 141149.CrossRefGoogle ScholarPubMed
Schou, M., Juel-Nielsen, N., Stromgren, E. & Voldby, H. (1954). The treatment of manic psychoses by the administration of lithium salts. Journal of Neurology, Neurosurgery and Psychiatry 17, 250260.CrossRefGoogle ScholarPubMed
Schou, M., Juel-Nielsen, N., Stromgren, E. & Voldby, H. (1955). Behandling of maniske psykoser med lithium. Ugeskrift for Laeger (Kobenhavn) 117, 93101.Google ScholarPubMed
Serry, M. (1969). Lithium retention and response. Lancet i, 12671268.CrossRefGoogle Scholar
Stallone, F., Shelley, E., Mendlewicz, J. & Fieve, R. R. (1973). The use of lithium in affective disorders. III. A double-blind study of prophylaxis in bipolar illness. American Journal of Psychiatry 130, 10061010.CrossRefGoogle Scholar
Stokes, J. W., Mendels, J., Secunda, S. K. & Dyson, W. L. (1972). Lithium excretion and therapeutic response. Journal of Nervous and Mental Disease 154, 4348.CrossRefGoogle ScholarPubMed
Trautner, E. M., Morris, R., Noack, C. H. & Gershon, S. (1955). The excretion and retention of ingested lithium and its effect on the ionic balance of man. Medical Journal of Australia 42, 280291.CrossRefGoogle ScholarPubMed
Tupin, J. P., Schlagenhauf, G. K. & Creson, D. L. (1968). Lithium effects on electrolyte excretion. American Journal of Psychiatry 125, 536543.CrossRefGoogle ScholarPubMed
Veall, N. & Vetter, H. (1958). Radio-isotope Techniques in Clinical Research and Diagnosis. Butterworth: London.Google Scholar
Wharton, R. N. & Fieve, R. R. (1966). The use of lithium in the affective psychoses. American Journal of Psychiatry 123, 706712.CrossRefGoogle ScholarPubMed
Winer, B.J. (1962). Statistical Principles in Experimental Design. McGraw-Hill: New York.CrossRefGoogle Scholar
Woollen, J. W. & Wells, M. G. (1973). Simple flame spectro-photometric assay of serum lithium. Annals of Chemical Biochemistry, 10, 8588.Google Scholar