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Lithium kinetics in single daily dosing.

P J Perry, F J Dunner, R L Hahn

    Acta Psychiatrica Scandinavica
    |October 1, 1981
    PubMed
    Summary
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    Single daily dosing of lithium carbonate is feasible for patients with recurrent bipolar disorder. This regimen maintained therapeutic lithium levels without altering kidney function, though it reduced urine output.

    Area of Science:

    • Pharmacology
    • Nephrology
    • Psychiatry

    Background:

    • Lithium carbonate is a cornerstone in managing bipolar disorder.
    • Optimizing lithium dosing regimens can improve patient adherence and reduce side effects.
    • Single daily dosing may offer convenience but requires careful evaluation of efficacy and safety.

    Purpose of the Study:

    • To assess the feasibility and impact of single daily dosing of lithium carbonate in patients with recurrent bipolar disorder.
    • To compare pharmacokinetic parameters and renal function between divided and single daily lithium doses.

    Main Methods:

    • Eight patients with recurrent bipolar disorder on lithium prophylaxis participated.
    • Patients received their entire 24-hour maintenance dose once daily at 8:00 p.m. for 12 days.

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  • Key parameters measured included serum lithium levels, lithium kinetics (half-life, clearance, volume of distribution), and renal function (serum creatinine, creatinine clearance, 24-hour urine output).

    • Main Results:

    • No significant changes were observed in lithium serum half-lives or renal lithium clearance.
    • Average steady-state lithium serum concentration (Cpss) remained unchanged with single daily dosing.
    • Serum creatinine and creatinine clearance showed no significant alterations, but a significant decrease in 24-hour urine output was noted.

    Conclusions:

    • Single daily dosing of lithium carbonate is a feasible alternative for lithium prophylaxis in bipolar disorder.
    • This dosing strategy effectively maintains therapeutic lithium serum concentrations without negatively impacting lithium clearance or overall renal function.
    • Clinicians should monitor for potential decreases in urine output when switching patients to a single daily lithium dose.