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Risk factors for the development of lithium-induced polyuria.

K L L Movig¹, R Baumgarten, H G M Leufkens

¹Hospital Pharmacy Midden-Brabant, Tilburg, The Netherlands.

The British Journal of Psychiatry : the Journal of Mental Science

|April 2, 2003

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Polyuria, or excessive urination, affects 37% of patients on lithium for bipolar disorder. Combining lithium with serotonergic antidepressants significantly increases this risk.

Area of Science:

Psychiatry
Pharmacology
Nephrology

Background:

Polyuria is a frequent side effect in patients with bipolar disorder undergoing lithium treatment.
Risk factors contributing to polyuria in this patient population remain largely uncharacterized.

Purpose of the Study:

To determine the prevalence of polyuria in patients using lithium.
To identify additional risk factors associated with lithium-induced polyuria.

Main Methods:

A prospective, 4-month follow-up study was conducted at an outpatient lithium clinic.
Seventy-five participants provided 24-hour urine samples, with polyuria defined as >3 liters/24h.
Evaluated risk factors included demographics, concurrent medications, and comorbidities.

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Main Results:

The prevalence of polyuria among lithium users was found to be 37%.
Concomitant use of serotonergic antidepressants showed a significant association with polyuria (OR 4.25, 95% CI 1.15-15.68).

Conclusions:

The study confirms a high prevalence of lithium-induced polyuria.
Concurrent use of serotonergic antidepressants with lithium substantially elevates the risk.
While not always harmful, polyuria can be bothersome, and lithium cessation may not be feasible for symptom control.