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Prophylactic efficacy of lithium administered every second day: a WHO multicentre study
P Plenge1, M Amin, A K Agarwal
1Department of Pharmacology, University of Copenhagen, Denmark. pp6102@rh.dk
Bipolar Disorders
|March 17, 2001
Summary
Lithium administered every second day is as effective as daily dosing for bipolar disorder and recurrent unipolar depression. This dosing schedule did not increase lithium side effects, offering a potentially more convenient prophylactic treatment.
Area of Science:
- Psychiatry
- Pharmacology
- Clinical Medicine
Background:
- Bipolar disorder and recurrent unipolar depression require long-term prophylactic treatment.
- Lithium is a well-established mood stabilizer for these conditions.
- Optimizing lithium dosing regimens can improve patient adherence and tolerability.
Purpose of the Study:
- To evaluate the prophylactic efficacy of administering lithium every second day.
- To compare the efficacy and side effect profile of alternate-day lithium dosing with daily dosing.
- To determine optimal serum lithium concentrations for alternate-day prophylaxis.
Main Methods:
- A WHO multicentre study involving 47 patients with bipolar disorder or recurrent unipolar depressive disorder.
- Patients initially received daily lithium for 2 months, then switched to an every-second-day regimen for 22 months.
- Serum lithium concentrations were monitored, and recurrence rates were compared to a preceding 2-year period.
Main Results:
- Alternate-day lithium administration was effective in 38 out of 47 patients.
- The recurrence rate did not differ significantly from the preceding daily dosing period.
- A 12-hour standard serum lithium concentration of 0.8 mmol/L or above was suggested for efficacy with alternate-day dosing.
- Lithium-related side effects were not influenced by the change in dosing frequency.
Conclusions:
- Lithium administered every second day is a viable prophylactic option for bipolar disorder and recurrent unipolar depression.
- This dosing strategy appears to maintain efficacy comparable to daily dosing.
- Alternate-day lithium dosing does not seem to increase the incidence or severity of side effects.
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