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Neuroleptics, lithium and renal function.

D G Waller, J G Edwards, A Polak

    The British Journal of Psychiatry : the Journal of Mental Science
    |May 1, 1985
    PubMed
    Summary
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    Neuroleptic drugs and lithium can impair kidney concentrating ability. Neuroleptic treatment showed a correlation with urinary beta 2-microglobulin excretion, suggesting potential renal effects.

    Area of Science:

    • Nephrology
    • Pharmacology
    • Toxicology

    Background:

    • Neuroleptic medications are widely used for psychiatric disorders.
    • Lithium is a common treatment for bipolar disorder.
    • Potential renal side effects of these medications warrant investigation.

    Purpose of the Study:

    • To compare renal function and tubular response to DDAVP in patients treated with neuroleptics versus lithium.
    • To assess the impact of neuroleptics and lithium on renal concentrating ability.

    Main Methods:

    • Compared renal function tests (serum creatinine, creatinine clearance, urinary albumin) in neuroleptic-treated patients, lithium-treated patients, and controls.
    • Assessed tubular response to DDAVP (desmopressin) to measure maximum urine concentrating ability.

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  • Measured urinary beta 2-microglobulin excretion in relation to treatment duration.

    • Main Results:

    • No significant abnormalities in serum creatinine, creatinine clearance, or urinary albumin were found in either treatment group.
    • Maximum urine concentrating ability after DDAVP was significantly reduced in the neuroleptic group compared to controls.
    • Urine concentrating ability was lower in the neuroleptic group than in the lithium group, but higher than controls.
    • Urinary beta 2-microglobulin excretion correlated with neuroleptic treatment duration, but mean rates were similar between groups.

    Conclusions:

    • Both neuroleptics and lithium appear to impair the kidney's urine concentrating ability.
    • Neuroleptic treatment duration may be associated with increased urinary beta 2-microglobulin excretion.
    • Further research is needed to fully elucidate the long-term renal effects of neuroleptic and lithium therapies.