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Lithium Levels in White Blood Cells and their Relationship to Observed Side Effects

Published online by Cambridge University Press:  29 January 2018

Yong Lock Ong*
Affiliation:
Department of Psychological Medicine, National University of Singapore, Sepoy Lines, Singapore 0316

Summary

A strong correlation was obtained between white blood cell (WBC) lithium concentrations and the severity of observed side effects in a group of 40 patients receiving prophylactic lithium therapy. However, there was no significant correlation between these levels and the specific side effect of hand tremor, although WBC concentrations were higher in patients with greater tremor. These results contrasted with those for plasma and red blood cell (RBC) lithium concentrations, which showed no relationship to side effects. This suggests that WBC lithium concentrations may be a more sensitive index of side effects than conventional plasma estimations.

Type
Research Article
Copyright
Copyright © 1983 The Royal College of Psychiatrists 

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References

Baron, D. N. (1979) Down with plasma! Intracellular chemical pathology studied by analysis of cells of solid tissue, erythrocytes and leucocytes. Proceedings of the Royal Society of Medicine, 62, 945–53.Google Scholar
Baron, D. N. & Ahmed, S. A. (1969) Intracellular concentrations of water and of the principle electrolytes determined by analysis of isolated human leucocytes. Clinical Sciences, 37, 205–19.Google Scholar
Beck, A. T., Ward, C. H., Mendelson, M., Mock, J. & Erbangh, J. (1961) An inventory for measuring depression. Archives of General Psychiatry, 4, 561–71.Google Scholar
Beigel, A. & Murphy, D. L. (1971) Assessing clinical characteristics of the manic state. American Journal of Psychiatry, 128, 688–94.Google Scholar
Blackburn, I. M., Lowdon, J. B. & Ashworth, C. M. (1977) A new scale for measuring mania. Psychological Medicine, 7, 453–8.CrossRefGoogle ScholarPubMed
Dorus, E., Pancley, G. N. & Davies, J. M. (1975) Genetic determinant of lithium ion in distribution. Archives of General Psychiatry, 32, 1097–102.CrossRefGoogle Scholar
Elizur, A., Shopsin, B., Gershon, S. & Ehlenberger, A. (1972) Intra extracellular lithium ratios and clinical course in effective states. Clinical Pharmacology and Therapeutics, 13, 947–52.CrossRefGoogle Scholar
Elizur, A., Graff, E., Steiner, M. & Davidson, S. (1977) Intra/extra red blood cell lithium and electrocyte distributed as correlates of neurotoxic reactions during lithium therapy. In The Impact of Biology on Modern Psychiatry. New York: Plenum Press.Google Scholar
Grof, P. (1979) Some practical aspects of lithium treatment. Archives of General Psychiatry, 36, 891–3.CrossRefGoogle ScholarPubMed
Gershon, S. & Shopsin, B. (1973) Pharmacology—toxicology of the lithium ion. In Lithium: Its Role in Psychiatric Research and Treatment, (eds. Gershon, S. and Shopsin, B.). New York: Plenum Press.CrossRefGoogle Scholar
Ghose, K. (1977) Lithium salts: Therapeutic and unwanted effects. British Journal of Hospital Medicine, 18, 578–83.Google Scholar
Hamilton, M. (1960) A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry, 23, 5662.CrossRefGoogle ScholarPubMed
Hewick, D. S. & Murray, N. (1976) Red blood cell levels and lithium toxicity. Lancet, ii, 28, 473.Google Scholar
Johnston, B. B., Dick, E. G., Naylor, G. J. & Dick, D. A. T. (1979) Lithium side effects in a routine lithium clinic. British Journal of Psychiatry, 134, 482–7.Google Scholar
Lee, C. R., Hill, S. E., Dimitrakendi, M., Jenner, F. A. & Pollet, R. J. (1978) The relationships of plasma to erythrocyte lithium levels in patients taking lithium carbonate. British Journal of Psychiatry, 127, 596–8.Google Scholar
Maggs, R. (1963) Treatment of manic illness with lithium carbonate. British Journal of Psychiatry, 109, 5665.Google Scholar
Perris, C. (1966) A study of bipolar/manic depressive and unipolar/recurrent depressive psychosis. Acta Psychiatrica Scandinavica Supplement, 194, 42.Google Scholar
Ratey, J. J. & Mallinger, A. G. (1977) The relationship between extra and intracellular lithium concentration in human red blood cells: an in vitro study. British Journal of Psychiatry, 131, 5962.CrossRefGoogle ScholarPubMed
Schou, M., Juel-Nielson, N., Stromgten, E. & Voldby, H. (1954) The treatment of manic psychoses by the administration of lithium salts. Journal of Neurology, Neurosurgery and Psychiatry, 17, 250–60.Google Scholar
Shopsin, B. (1970) Effect of lithium on thyroid function: a review. Diseases of the Nervous System, 31, 237–44.Google ScholarPubMed
Shopsin, B., Johnson, G. & Ghershon, S. (1971) Neurotoxity with lithium. Differences during responsiveness. International Pharmacopsychiatry, 5, 2–4, 162–70.Google Scholar
Stokes, P. E., Stoli, P. M., Shamoian, C. A. & Patton, M. J. (1971) Efficiency of lithium as acute treatment of manic-depressive illness. Lancet, i, 1319–25.Google Scholar
Zabrowska-Dabrowska, T. & Rybakowski, J. (1973) Lithium-induced EEG changes; relation to lithium levels in serum and red blood cells. Acta Psychiatrica Scandinavica, 49, 457–65.Google Scholar
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