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Lithium Erythrocyte Concentration and Neurological Toxicity in Bipolar Disorder
Author(s) -
AhmadiAbhari Seyed Ali,
Farhoodian Ali,
Noroozian Maryam,
Ghaeli Padideh,
DashtiKhavidaki Simin,
Sadeghi Mandana,
Dehpour AhmadReza,
Fahimi Fanak
Publication year - 2005
Publication title -
journal of pharmacy practice and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.222
H-Index - 22
eISSN - 2055-2335
pISSN - 1445-937X
DOI - 10.1002/j.2055-2335.2005.tb00316.x
Subject(s) - lithium (medication) , medicine , adverse effect , gastroenterology
Aim To investigate the relationship between lithium‐induced neurotoxicity and plasma lithium concentration, erythrocyte lithium concentration, and lithium ratio. Method The relationship between lithium‐induced adverse effects and three laboratory indices (plasma lithium concentration, erythrocyte lithium concentration, lithium ratio) were assessed in 18 patients with bipolar type 1 disorder. Adverse effects after 6 weeks therapy were assessed with the Extrapyramidal Symptom Rating Scale (ESRS1–4), Abnormal Involuntary Movement (AIMS) and Mini Mental Status Examination (MMSE) and the clinical evaluation of tandem walk, rapid alternative test, tremor, myoclonus and muscle force. Results Median erythrocyte lithium concentration in patients with increased or new incidence of impaired rapid alternative test was significantly high. Changes in ESRS1, ESRS4 and total ESRS had positive correlations with erythrocyte and plasma lithium concentrations. ESRS2 and AIMS had better correlations with erythrocyte lithium concentrations. There was no relationship between erythrocyte concentration, plasma concentration or lithium ratio and worsening of tremor, reduced muscular tone, myoclonus or impaired tandem walk. Conclusion Lithium erythrocyte concentration may help to predict susceptibility to neurological toxicity better than plasma concentration. This could help identify patients who will not be good candidates for lithium due to predictable adverse effects.