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Supervising Lithium a Comparison of a Lithium Clinic, Psychiatric Out-patient Clinics, and General Practice

Published online by Cambridge University Press:  02 January 2018

George Masterton ,
Mary Warner  and
Brian Roxburgh
George Masterton*
Affiliation:
Yeovil District Hospital and Tone Vale Hospital, Bishop's Lydeard, Taunton
Mary Warner
Affiliation:
Yeovil District Hospital
Brian Roxburgh
Affiliation:
Tone Vale Hospital
*
∗Royal Infirmary of Edinburgh, Lauriston Place, Edinburgh EH3
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Abstract

Supervision of lithium treatment among three groups of patients treated in different settings – at a lithium clinic, as hospital out-patients, and by a GP – was studied. The lithium clinic maintained lower levels and checked these more frequently. Elevated lithium levels were most frequent in the GP-supervised group, which also included the 13 patients with the most impaired glomerular filtration. In hospital settings GFR-impaired patients received a lower daily dose of lithium; in general practice, affected patients had a higher mean serum lithium level and were more frequently prescribed lithium once daily. We conclude that patients with glomerular impairment who require lithium should be supervised by a specialist, or at least prescribed lithium in divided daily doses.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 152 , Issue 4 , April 1988 , pp. 535 - 538
Copyright
Copyright © Royal College of Psychiatrists, 1988 

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References

Amdisen, A. (1977) Serum level monitoring and clinical pharmacokinetics of lithium. Clinical Pharmacokinetics, 2, 73–92.Google Scholar
Bendz, H. (1983) Kidney function in lithium treated patients. Acta Psychiatrica Scandinavica, 68, 303–324.Google Scholar
Bjornsson, T. D. (1979) Use of serum creatinine concentrations to determine renal function. Clinical Pharmacokinetics, 4, 200–222.Google Scholar
Brøchner-Mortensen, J., Jensen, S. & Rødbro, P. (1977) Delimitation of plasma creatinine concentration values for assessment of relative renal function in adult patients. Scandinavian Journal of Urology and Nephrology, 11, 257–262.Google Scholar
Enger, E. & Blegen, E. M. (1964) The relationship between creatinine clearance and serum creatinine in renal failure. Scandinavian Journal of Clinical and Laboratory Investigation, 16, 273–280.Google Scholar
Jacobsen, F. K., Christensen, C. K., Mogensen, C. F., Andreasen, F. & Heilskov, N. S. C. (1979) Pronounced increase in serum creatinine concentration after eating cooked meat. British Medical Journal, i, 1049–1050.Google Scholar
Masterton, G. & Warner, M. (1985) Poor response when laboratory recommended range for serum lithium is changed. The Lancet, i, 981.Google Scholar
McCreadie, R. G. & Morrison, D. P. (1985) The impact of lithium in south-west Scotland 1. Demographic and clinical findings. British Journal of Psychiatry, 146, 70–74.Google Scholar
Perry, P. J. (1982) Lithium nephrotoxicity. Drug Intelligence and Clinical Pharmacy, 16, 740–744.Google Scholar
Perry, P. J., Dunner, F. J., Mahn, R. L., Tsuang, M. L. & Berg, M. J. (1981) Lithium kinetics in single daily dosing. Acta Psychiatrica Scandinavica, 64, 281–294.Google Scholar
Plenge, P., Mellerup, E. T., Bolwig, T. G., Brun, C., Hetmar, O., Ladefoged, J., Larsen, S. & Rafaelson, O. J. (1982) Lithium treatment: does the kidney prefer one daily dose instead of two? Acta Psychiatrica Scandinavica, 66, 121–128.Google Scholar
Plenge, P., Mellerup, E. T. & Norgaard, T. (1981) Functional and structural rat kidney changes caused by peroral or parenteral lithium treatment. Acta Psychiatrica Scandinavica, 63, 303–313.Google Scholar
Rosano, T. G. & Brown, H. H. (1982) Analytical and biological variability of serum creatinine and creatinine clearances: implication for clinical interpretation. Clinical Chemistry, 28, 2330–2331.Google Scholar
Schou, M., Amdisen, A., Thomsen, K., Vestergaard, P., Hetmar, O., Mellerup, E. T., Plenge, P. & Rafaelson, O. J. (1982) Lithium treatment regimen and renal water handling: the significance of dosage pattern and tablet type examined through comparison of results from two clinics with different treatment regimens. Psychopharmacology, 77, 377–390.Google Scholar
Shaw, D. M. (1980) The context of lithium therapy. In Handbook of Lithium Therapy (ed. Johnson, F. N.). Lancaster: MTP Press Limited.Google Scholar
Spencer, K. (1986) Analytical reviews in clinical biochemistry: the estimation of creatinine. Annals of Clinical Biochemistry, 23, 1–25.Google Scholar
Swaminathan, R., Ho, C. S., Chu, Lau Ming & Donnan, S. (1986) Relation between plasma creatinine and body size. Clinical Chemistry, 32, 371–373.Google Scholar
Vestergaard, P. (1980) Renal side effects of lithium. In Handbook of Lithium Therapy (ed. Johnson, F. N.). Lancaster: MTP Press Limited.Google Scholar
Walker, R. G., Bennett, W. M., Davies, B. D., & Kincaid-Smith, P. (1982) Structural and functional effects of long-term lithium therapy. Kidney International, 21, 513–519.Google Scholar
Waller, D. G. & Edwards, J. G. (1985) Investigating renal function during lithium treatment. Psychological Medicine, 15, 369–375.Google Scholar
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