Hostname: page-component-8448b6f56d-sxzjt Total loading time: 0 Render date: 2024-04-24T07:37:22.115Z Has data issue: false hasContentIssue false

A Review and Controlled Study of Cutaneous Conditions associated with Lithium Carbonate

Published online by Cambridge University Press:  29 January 2018

Brent Waters
Affiliation:
Affective Disorders Clinic Royal Ottawa Hospital, Ontario KIZ 7K4, Canada

Summary

This study compares the incidence of a variety of cutaneous conditions among 91 patients treated with lithium carbonate with the incidence of such conditions among 44 patients treated with other non-neuroleptic, maintenance medications. Data on cutaneous conditions and allergies were obtained using structured interviews, demographic data, medication histories and personal and family histories.

A significantly greater proportion of the lithium-treated patients than the comparison patients reported a cutaneous condition which may have been secondary to treatment in that it developed for the first time after the medication or appeared to have been exacerbated by the medication. Among the lithium-treated patients, females were found to be significantly more likely to report a secondary cutaneous condition. This effect was found across the whole range of cutaneous conditions. Male lithium-treated patients on the other hand reported approximately the same rate of secondary cutaneous conditions as both male and female comparison patients. Possible reasons for this sexual effect on incidence are discussed.

The literature on cutaneous conditions which have been associated with lithium therapy is also reviewed.

Type
Research Article
Copyright
Copyright © 1983 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

American Psychiatric Association (1980) DSM III: Diagnostic and Statistical Manual for Mental Disorders, (Third Edition). Washington: American Psychiatric Association.Google Scholar
Bakker, J. & Pepplinkhuizen, L. (1976) More about the relationship of lithium to psoriasis. Psychosomatics, 17, 143–6.Google Scholar
Ban, T. A. (1978) Adverse effects in maintenance therapy. International Pharmacopsychiatry, 13, 217–29.Google Scholar
Bech, P., Thomsen, J., Prytz, S., Vendsborg, P. B., Zilstorff, K. & Rafaelsen, O. J. (1979) The profile and severity of lithium-induced side-effects in mentally healthy subjects. Neuropsychobiology, 5, 160–6.Google Scholar
Belmaker, R. (1981) Receptors, adenylate cyclase depression and lithium. Biological Psychiatry, 16, 333–50.Google ScholarPubMed
Bone, S., Roose, P. S., Dunner, L. D. & Fieve, R. R. (1980) Incidence of side-effects in patients on long-term lithium therapy. American Journal of Psychiatry, 137, 103–4.Google Scholar
Brown, W. T. (1976) Side-effects of lithium therapy and their treatment. Canadian Psychiatric Association Journal, 21, 1321.CrossRefGoogle ScholarPubMed
Callaway, L. C., Hendrie, C. H., & Luby, D. F. (1968) Cutaneous conditions observed in patients during treatment with lithium. American Journal of Psychiatry, 124, 1124–5.Google Scholar
Carter, T. N. (1972) The relationship of lithium carbonate to psoriasis. Psychosomatics, 13, 325–7.Google Scholar
Christodoulou, N. G., Siafakas, A. & Rinieris, M. P. (1977) Side-effects of lithium. Acta Psychiatrica Belgica, 77, 260–6.Google Scholar
Digiovanni, J., Aoyagi, T., Taylor, R. & Halprin, K. (1981) Inhibition of epidermal adenylcyclase by lithium carbonate. Journal of Investigative Dermatology, 76, 259–63.Google Scholar
Evans, L. D. & Martin, W. (1979) Lithium carbonate and psoriasis. American Journal of Psychiatry, 136, 1326–7.Google Scholar
Forn, J. (1975) Lithium and cyclic AMP. in Lithium Research and Therapy (ed. Johnson, F. N.). London: Academic Press.Google Scholar
Gelfand, E. W., Dosch, H. M., Hastings, D. & Shore, A. (1979) Lithium: a modulator of cyclic AMP-Dependant events in lymphocytes? Science, 203, 365–7.Google Scholar
Hoxtell, E. & Dahl, M. (1975) Xerosis from lithium carbonate. Archives of Dermatology, 111, 1073–4.Google Scholar
Johnson, F. N. & Vacaflor, L. (1975) Lithium side-effects and toxicity: mechanisms. In Lithium Research and Therapy, (ed. Johnson, F. N.), London: Academic Press.Google Scholar
Johnson, B. B., Dick, G. E., Naylor, J. G. & Dick, T. A. (1979) Lithium side-effects in a routine lithium clinic. British Journal of Psychiatry, 134, 482–7.Google Scholar
Kuhnley, J. E. & Granoff, L. A. (1979) Exfoliative dermatitis during lithium treatment. American Journal of Psychiatry, 136, 1340–1.Google Scholar
Kusumi, Y. (1971) A cutaneous side-effect of lithium: report of 2 cases. Diseases of the Nervous System, 32, 853–4.Google Scholar
Lindstedt, G., Nilsson, L., Walinder, J., Scott, A. & Ohmay, R. (1977) On the prevalence, diagnosis and management of lithium-induced hypothroidism in psychiatric patients. British Journal of Psychiatry, 130, 452–8.Google Scholar
Lowe, J. N. & Ridgway, B. H. (1978) Generalized pustular psoriasis precipitated by lithium carbonate. Archives of Dermatology, 114, 1788–9.Google Scholar
Mason, A. & Granacher, R. P. (1980) Clinical Handbook of Antipsychotic Drug Therapy, 277. New York: Brunner/Mazel.Google Scholar
Meinhold, J. M., West, D. P., Burwich, E., Spirit, A. & Koye, D. (1980) Cutaneous reaction to lithium carbonate. Journal Clinical Psychiatry, 41, 395–6.Google Scholar
Muniz, D. & Bergman, D. (1978) Contact stomatitis and lithium carbonate tablets. Journal of the American Medical Association, 239, 2759.Google Scholar
O'Connell, R. (1971) Lithium site of action: clues from side-effects. Comprehensive Psychiatry, 12, 224–9.CrossRefGoogle ScholarPubMed
Oei, T. T. & Bour, D. J. H. (1978) Acne exacerbation on lithium therapy. Nederlands Tijdschrift voor Geneeskunde, 122, 1302–3.Google Scholar
Okrasinski, H. (1977) Lithium acne. Dermatologica, 154, 251–3.Google Scholar
Persson, G. (1977) Lithium side-effects in relation to dose and to levels and gradients of lithium in plasma. Acta Psychiatrica Scandinavica, 55, 208–13.Google Scholar
Posey, R. E. (1972) Lithium carbonate dermatitis. Journal of the American Medical Association, 221, 1517.Google Scholar
Reiffers, J. & Dick, P. (1977) Cutaneous side-effects of treatment with lithium. Dermatologica, 155, 155–63.Google Scholar
Reisberg, B. & Gershon, S. (1979) Side-effects associated with lithium therapy. Archives of General Psychiatry, 36, 879–86.Google Scholar
Rifkin, A., Kuztin, S., Quitkin, F. & Klein, D. (1973) Lithium-induced folliculitis. American Journal of Psychiatry, 130, 1018–9.Google Scholar
Ruiz-Maldonado, R. R., Perez de Francisco, C. & Taunayo, L. (1973) Lithium dermatitis. Journal of the American Medical Association, 224, 1534.Google Scholar
Scott, A., Mobacker, H. & Starmark, E. J. (1977) Exacerbation of psoriasis during lithium treatment. British Journal of Dermatology, 96, 445–7.Google Scholar
Skoven, J. & Thormann, J. (1979) Lithium compound treatment and psoriasis. Archives of Dermatology, 115, 1185–6.Google Scholar
Slorach, J. (1953) Emotional factors in skin disease. in Skin and Psychoses (ed. Wittkower, E. and Russell, B.). London: Cassell.Google Scholar
Swartz, C. M. & Holkesvick, R. (1981) Mitigating acute skin rashes and nausea from lithium. Comprehensive Psychiatry, 22, 301–5.Google Scholar
Vacaflor, L. (1975) Lithium side-effects and toxicity: the clinical picture. in Lithium Research and Therapy (ed. Johnson, F. N.). London: Academic Press.Google Scholar
Vestergaard, P., Arndisen, A. & Schou, M. (1980) Clinically significant side-effects of lithium treatment. Acta Psychiatrica Scandinavica, 62, 193200.Google Scholar
Voorhees, J., Dwell, E. & Arbor, A. (1971) Psoriasis as a possible defect of the adenylcyclase–cyclic AMP cascade. Archives of Dermatology, 104, 352–8.Google Scholar
Wright, R. K., Mandy, S., Halprin, K. & Hsia, S. (1973) Defects and deficiency of adeylcyclase in psoriatic skin. Archives of Dermatology, 107, 4753.Google Scholar
Yoder, F. W. (1975) Acneiform eruption due to lithium carbonate. Archives of Dermatology, 111, 396–7.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.