Plus ça change? Switching lithium preparations
David A Cousins1,2, Thomas R E Barnes3,4, Allan H Young5,6
1Newcastle University, Newcastle upon Tyne, UK.
Bjpsych Bulletin
|February 18, 2022
Summary
Switching lithium carbonate brands, like Priadel® to Camcolit®, showed similar plasma lithium levels in adherent patients. This suggests current guidance on switching lithium brands may be overly complex.
Area of Science:
- Pharmacokinetics
- Clinical Pharmacy
- Drug Efficacy
Background:
- A 2020 supply disruption alert prompted a switch from Priadel® (lithium carbonate) tablets.
- Prescribers needed to understand the interchangeability of different lithium brands.
Purpose of the Study:
- To evaluate lithium plasma levels and dosage before and after brand switching.
- To determine the pharmacokinetic interchangeability of lithium carbonate brands.
Main Methods:
- Service evaluation analyzing data from 37 patients.
- Compared plasma lithium levels pre- and post-switch between brands.
Main Results:
- Switching from Priadel® to Camcolit® at the same dose showed no significant plasma lithium level differences.
- Dose adjustments and poor adherence correlated with higher plasma lithium variability.
Conclusions:
- Common lithium carbonate brands yield similar plasma levels in adherent patients at comparable doses.
- Current British National Formulary guidance for switching lithium brands may be unnecessarily complex.
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