Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-22T08:27:54.507Z Has data issue: false hasContentIssue false

Neuroleptics, Lithium and Renal Function

Published online by Cambridge University Press:  29 January 2018

Derek G. Waller*
Affiliation:
University of Southampton, Southampton General Hospital, Southampton, SO9 4XY
J. Guy Edwards
Affiliation:
Department of Psychiatry, Royal South Hants Hospital, Southampton, SO9 4PE
A. Polak
Affiliation:
University of Southampton, St. Mary's Hospital, Portsmouth, PO3 6AD
*
Correspondence.

Summary

Renal function test results in 26 patients on neuroleptic treatment, who had never received lithium or antidepressants, were compared with those in a matched group, treated with lithium; also, their tubular response to DDAVP was compared with that of 25 control subjects. Measurements of serum creatinine, creatinine clearance, and urinary albumin excretion showed no abnormality attributable to either neuroleptics or lithium. The maximum urine concentrating ability after DDAVP was significantly lower in the neuroleptic group than in controls, but significantly higher than in the lithium-treated patients. There was a significant correlation between excretion of urinary ß2-microglobulin and duration of neuroleptic treatment, but mean excretion rates were the same in both treatment groups. The results suggest that neuroleptics as well as lithium impair urine concentrating ability.

Type
Research Article
Copyright
Copyright © 1985 The Royal College of Psychiatrists 

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

Bendz, H., Andersen, S. & Aurell, M. (1983) Kidney function in an unselected lithium population. A cross-sectional study. Acta Psychiatrica Scandinavica. 68, 325334.CrossRefGoogle Scholar
Black, D. A. K. (1965) Renal rete mirabile. In Lancet ii, 11411151.Google Scholar
Bjornsson, T. (1979) Use of serum creatinine concentrations to determine renal function. Clinical Pharmacokinetics, 4, 200222.Google Scholar
Bucht, G. & Wahlin, A. (1980) Renal concentrating capacity in long term lithium treatment after withdrawal of lithium. Acta Medica Scandinavica, 207, 309314.Google Scholar
Cockcroft, D. & Gault, M. H. (1976) Prediction of creatinine clearance from serum creatinine. Nephron, 16, 3141.Google Scholar
Coppen, A., Cattell, W. R. & Price, R. G. (1980) Renal function in lithium and non-lithium treated patients with affective disorders. Acta Psychiatrica Scandinavica, 62, 343355.Google Scholar
Ellis, G. G., Coppen, A. & Glen, A. I. M. (1970) Urine concentration in depressive illness. Journal of Neurology, Neurosurgery and Psychiatry, 34, 3031.Google Scholar
Evrin, P. E. & Wibell, L. (1972) The serum levels and urinary excretion of β2 microglobulin in apparently healthy subjects. Scandinavian Journal of Clinical and Laboratory Medicine. 29, 6974.Google Scholar
Garvey, M. J., Tuason, V. B., Blomqvist, C. H. & Hwang, S. (1982) Use of renal enzymes to evaluate nephrotoxicity in lithium treated patients. British Journal of Psychiatry, 141, 420422.CrossRefGoogle ScholarPubMed
Gelenberg, A. J., Wojcik, J. D., Coggins, C. H., Rosenbaum, J. F. & LaBrie, R. A. (1981) Renal function monitoring in patients receiving lithium carbonate. Journal of Clinical Psychiatry. 42, 428431.Google Scholar
Hansen, H. E., Mogensen, C. E., Sorensen, J. L., Norgaard, K., Heilskov, J. & Amdisen, A. (1981) Albumin and beta2-microglobulin excretion in patients on long-term lithium treatment. Nephron. 29, 229232.Google Scholar
Hullin, R. P., Coley, V. P., Birch, N. J., Thomas, T. H. & Morgan, D. B. (1979) Renal function after long-term treatment with lithium. British Medical Journal, i, 14571459.Google Scholar
Mancini, G., Carbonara, A. O. & Heremans, J. F. (1965) Immunochemical quantification of antigens by single radial immunodiffusion. International Journal of Immunochemistry. 2, 235254.Google Scholar
Miller, M., Dalakos, T., Moses, A. M., Fellerman, H. & Streeten, D. H. P. (1970) Recognition of partial defects in antidiuretic hormone secretion. Annals of Internal Medicine. 73, 721725.Google Scholar
Mogensen, C. E., Vittinghus, E. & Solling, K. (1979) Abnormal albumin excretion after two provocative renal tests in diabetes: physical exercise and lysine excretion. Kidney International. 16, 385393.Google Scholar
Monson, J. P. & Richards, P. (1978a) Desmopressin urine concentration test. British Medical Journal, 1, 2425.Google Scholar
Monson, J. P. & Richards, P. (1978b) Age and urine concentration after desmopressin. British Medical Journal, 2, 10541055.Google Scholar
Ryan, T. A. Jr., Joiner, B. L. & Ryan, B. F. (1981) Minitab Users Handbook. Boston: Duxbury Press.Google Scholar
Smith, W. O. & Clark, M. L. (1980) Self-induced water intoxication in schizophrenic patients. American Journal of Psychiatry, 137, 10551060.Google Scholar
Thysell, H., Hultberg, B. & Regnell, G. (1982) Urinary β-hexosaminidase excretion in patients treated with lithium, thymoleptic and/or neuroleptic drugs. Acta Psychiatrica Scandinavica, 66, 486490.Google Scholar
Tucker, S. M., Boyd, P. J. R., Thompson, A. E. & Price, R. G. (1975) Automated assay of N-acetyl-β-glucosaminidase in normal and pathological urine. Clinica Chimica Acta, 62, 333339.Google Scholar
Tyrer, S. P., McArthey, M. J., Shopsin, B. & Schacht, R. G. (1980) Lithium and the kidney. Lancet, 1, 495.Google Scholar
Vestergaard, P., Amdisen, A., Hansen, H. E. & Schou, M. (1979) Lithium treatment and kidney function. A survey of 237 patients on long-term treatment. Acta Psychiatrica Scandinavica, 60, 504520.Google Scholar
Waller, D. G., Edwards, J. G., Naik, R. & Polak, A. (1984) Renal function during lithium treatment. Quarterly Journal of Medicine, 211, 369379.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.