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Lithium dosing

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https://www.readbyqxmd.com/read/28645191/how-effective-is-algorithm-guided-treatment-for-depressed-inpatients-results-from-the-randomized-controlled-multicenter-german-algorithm-project-3-trial
#1
Mazda Adli, Katja Wiethoff, Thomas C Baghai, Robert Fisher, Florian Seemüller, Gregor Laakmann, Peter Brieger, Joachim Cordes, Jaroslav Malevani, Gerd Laux, Iris Hauth, Hans-Jürgen Möller, Klaus-Thomas Kronmüller, Michael N Smolka, Peter Schlattmann, Maximilian Berger, Roland Ricken, Thomas J Stamm, Andreas Heinz, Michael Bauer
Background: Treatment algorithms are are considered as key to improve outcomes by enhancing the quality of care. This is the first randomized controlled study to evalutate the clinical effect of algorithm-guided treatment in inpatients with major depressive disorder (MDD). Methods: Inpatients, aged 18-70 years with MDD from 10 German psychiatric departments were randomized to 5 different treatment arms (from 2000 to 2005), three of which were standardized stepwise drug treatment algorithms (ALGO)...
June 22, 2017: International Journal of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28604590/lithium-in-drinking-water-and-incidence-of-suicide-a-nationwide-individual-level-cohort-study-with-22-years-of-follow-up
#2
Nikoline N Knudsen, Jörg Schullehner, Birgitte Hansen, Lisbeth F Jørgensen, Søren M Kristiansen, Denitza D Voutchkova, Thomas A Gerds, Per K Andersen, Kristine Bihrmann, Morten Grønbæk, Lars V Kessing, Annette K Ersbøll
Suicide is a major public health concern. High-dose lithium is used to stabilize mood and prevent suicide in patients with affective disorders. Lithium occurs naturally in drinking water worldwide in much lower doses, but with large geographical variation. Several studies conducted at an aggregate level have suggested an association between lithium in drinking water and a reduced risk of suicide; however, a causal relation is uncertain. Individual-level register-based data on the entire Danish adult population (3...
June 10, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28592271/simulating-therapeutic-drug-monitoring-results-for-dose-individualisation-to-maintain-investigator-blinding-in-a-randomised-controlled-trial
#3
Maia Lesosky, John Joska, Eric Decloedt
BACKGROUND: Therapeutic drug monitoring (TDM) is essential practice when dosing drugs with a narrow therapeutic index in order to achieve a plasma drug concentration within a narrow target range above the efficacy concentration but below the toxicity concentration. However, TDM with dose individualisation is challenging during a double-blind clinical trial with laboratory staff and investigators blinded to treatment arm allocation. METHODS: Drug concentrations were simulated for participants in the placebo arm by an unblinded independent statistician, utilising the measured values from the treatment arm participants...
June 7, 2017: Trials
https://www.readbyqxmd.com/read/28591541/lithium-use-in-pregnancy-and-the-risk-of-cardiac-malformations
#4
COMPARATIVE STUDY
Elisabetta Patorno, Krista F Huybrechts, Brian T Bateman, Jacqueline M Cohen, Rishi J Desai, Helen Mogun, Lee S Cohen, Sonia Hernandez-Diaz
BACKGROUND: There has been concern that exposure to lithium early in pregnancy may be associated with a marked increase in the risk of Ebstein's anomaly (a right ventricular outflow tract obstruction defect) in infants and overall congenital cardiac defects, but data are conflicting and limited. METHODS: We conducted a cohort study involving 1,325,563 pregnancies in women who were enrolled in Medicaid and who delivered a live-born infant between 2000 and 2010. We examined the risk of cardiac malformations among infants exposed to lithium during the first trimester as compared with unexposed infants and, in secondary analyses, with infants exposed to another commonly used mood stabilizer, lamotrigine...
June 8, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28585859/evaluation-of-the-potential-for-drug-interactions-with-patiromer-in-healthy-volunteers
#5
Lawrence J Lesko, Elliot Offman, Christine Taylor Brew, Dahlia Garza, Wade Benton, Martha R Mayo, Alain Romero, Charles Du Mond, Matthew R Weir
INTRODUCTION: Patiromer is a potassium-binding polymer that is not systemically absorbed; however, it may bind coadministered oral drugs in the gastrointestinal tract, potentially reducing their absorption. METHODS: Twelve randomized, open-label, 3-period, 3-sequence crossover studies were conducted in healthy volunteers to evaluate the effect of patiromer (perpetrator drug) on absorption and single-dose pharmacokinetics (PK) of drugs (victims) that might be commonly used with patiromer...
January 1, 2017: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28575066/combined-application-of-arsenic-trioxide-and-lithium-chloride-augments-viability-reduction-and-apoptosis-induction-in-human-rhabdomyosarcoma-cell-lines
#6
Sabine B Schleicher, Julian J Zaborski, Rosa Riester, Natascha Zenkner, Rupert Handgretinger, Torsten Kluba, Frank Traub, Karen A Boehme
Rhabdomyosarcomas (RMS) are the most prevalent soft tissue sarcomas affecting children and adolescents. Despite intensive treatment consisting of multimodal chemotherapy and surgery RMS patients diagnosed with metastatic disease expect long term survival rates of only 20%. Often multidrug resistance arises upon initial response emphasizing the need for new therapeutic drugs to improve treatment efficiency. Previously, we demonstrated the efficacy of the FDA approved drug arsenic trioxide (ATO) specifically inhibiting viability and clonal growth as well as inducing cell death in human RMS cell lines of different subtypes...
2017: PloS One
https://www.readbyqxmd.com/read/28561179/-lithium-treatment-in-patients-with-impaired-kidney-function-between-scylla-and-charybdis
#7
Julia Dehning, Heinz Grunze, Christoph Born, Armand Hausmann
Introduction In quite a few patients with bipolar disorder there is no real alternative to lithium treatment despite impaired kidney function. Is it possible to continue lithium treatment despite kidney malfunction by changing dosage and/or frequency of administration? Case Report We report on a 65-year-old woman suffering from bipolar-I disorder who had been on lithium treatment for many decades. While on lithium, the glomerular filtration rate (GFR) decreased constantly. A decision had to be made whether to switch to a more tolerable o...
May 2017: Fortschritte der Neurologie-Psychiatrie
https://www.readbyqxmd.com/read/28555320/population-pharmacokinetic-analyses-of-lithium-a-systematic-review
#8
REVIEW
Janthima Methaneethorn
BACKGROUND AND OBJECTIVES: Even though lithium has been used for the treatment of bipolar disorder for several decades, its toxicities are still being reported. The major limitation in the use of lithium is its narrow therapeutic window. Several methods have been proposed to predict lithium doses essential to attain therapeutic levels. One of the methods used to guide lithium therapy is population pharmacokinetic approach which accounts for inter- and intra-individual variability in predicting lithium doses...
May 29, 2017: European Journal of Drug Metabolism and Pharmacokinetics
https://www.readbyqxmd.com/read/28550195/dipeptidyl-peptidase-4-inhibition-stimulates-distal-tubular-natriuresis-and-increases-in-circulating-sdf-1%C3%AE-1-67-in-patients-with-type-2-diabetes
#9
Julie A Lovshin, Harindra Rajasekeran, Yulyia Lytvyn, Leif E Lovblom, Shajiha Khan, Robel Alemu, Amy Locke, Vesta Lai, Huaibing He, Lucinda Hittle, Weixun Wang, Daniel J Drucker, David Z I Cherney
OBJECTIVE: Antihyperglycemic agents, such as empagliflozin, stimulate proximal tubular natriuresis and improve cardiovascular and renal outcomes in patients with type 2 diabetes. Because dipeptidyl peptidase 4 (DPP-4) inhibitors are used in combination with sodium-glucose cotransporter 2 (SGLT-2) inhibitors, we examined whether and how sitagliptin modulates fractional sodium excretion and renal and systemic hemodynamic function. RESEARCH DESIGN AND METHODS: We studied 32 patients with type 2 diabetes in a prospective, double-blind, randomized, placebo-controlled trial...
May 26, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28535438/determination-of-edoxaban-equivalent-concentrations-in-human-plasma-by-an-automated-anti-factor-xa-chromogenic-assay
#10
Ling He, Jarema Kochan, Min Lin, Alexander Vandell, Karen Brown, Francois Depasse
INTRODUCTION: This phase I, open-label, multiple-dose, two-treatment study assessed the relationship between edoxaban equivalent concentration derived from an anti-FXa assay with the summed concentration of edoxaban and its active metabolite, M-4, as assessed by liquid chromatography coupled with tandem mass spectrometry (LC/MS/MS). This study also assessed the relationship between edoxaban plasma concentrations assessed by LC/MS/MS in sodium citrate and lithium heparin tubes. MATERIALS AND METHODS: Healthy volunteers were randomized to receive once-daily edoxaban 60mg or 90mg for 5days (15 participants per treatment group)...
May 7, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28529112/myeloid-differentiation-factor-88-is-up-regulated-in-epileptic-brain-and-contributes-to-experimental-seizures-in-rats
#11
Na Wang, Xiong Han, Haipeng Liu, Ting Zhao, Jie Li, Yan Feng, Xiujuan Mi, Yanke Zhang, Yanan Chen, Xuefeng Wang
Accumulating evidence supports that activation of inflammatory pathways is a crucial factor contributing to the pathogenesis of seizures. In particular, the activation of interleukin-1 beta (IL-1β) system exerts proconvulsant effects in a large variety of seizure models. Myeloid differentiation factor 88 (MyD88) is a critical adaptor protein in the signaling cascade elicited by IL-1β. The present study aimed to investigate the expression pattern of MyD88 in rat models of seizures and in patients with refractory temporal lobe epilepsy (TLE), and to study the role of MyD88 in epileptic seizures...
May 18, 2017: Experimental Neurology
https://www.readbyqxmd.com/read/28527265/-profile-of-lithium-carbonate-use-in-patients-with-bipolar-disorder-in-colombia
#12
Manuel Enrique Machado-Duque, Catalina Alzate-Carvajal, Kevin Zapata-Castañeda, Jorge Enrique Machado-Alba
INTRODUCTION: Lithium is the drug of choice for the treatment of bipolar affective disorder. OBJECTIVE: To define lithium therapeutic profile and adverse reactions to its use in patients with bipolar affective disorder in Colombia. MATERIALS AND METHODS: We conducted an observational retrospective cohort study between January 1 and December 31, 2013, which included patients with a diagnosis of bipolar disorder treated with lithium carbonate in 25 Colombian cities; we evaluated socio-demographic variables, lithium dose, co-medication, drug interactions and adverse reactions...
April 1, 2017: Biomédica: Revista del Instituto Nacional de Salud
https://www.readbyqxmd.com/read/28525197/-treatment-resistant-depression-actuality-and-perspectives-in-2017
#13
REVIEW
N Lucas, P Hubain, G Loas, F Jurysta
Major depressive disorder (MDD) affects 3 to 17 % of adults. 15 to 30 % of patients with MDD suffer from treatment resistant depression (TRD). No international consensus defines TRD. The most common definition is " MDD that is not enough improved after two successive and different classes of antidepressant treatments in appropriate dose and duration ". The appropriate dose corresponds to maximal dose accepted by scientific reports and clinical recommendations, while the appropriate duration is around 6 weeks...
2017: Revue Médicale de Bruxelles
https://www.readbyqxmd.com/read/28513760/cell-therapy-in-the-treatment-of-bipolar-mania-in-an-animal-model-a-proof-of-concept-study
#14
Bruna M Ascoli, Rafael Colombo, Luiza P Géa, Paula B Terraciano, Sabrina B Pizzato, Fernanda S de Oliveira, Elizabeth Cirne-Lima, Flávio Kapczinski, Adriane R Rosa
Introduction: The rationale of mesenchymal stem cells (MSCs) as a novel therapeutic approach in certain neurodegenerative diseases is based on their ability to promote neurogenesis. Hippocampal atrophy has been related to bipolar disorder (BD) in preclinical, imaging and postmortem studies. Therefore, the development of new strategies to stimulate the neurogenesis process in BD is crucial. Objectives: To investigate the behavioral and neurochemical changes induced by transplantation of MSCs in a model of mania-like behavior induced by lisdexamfetamine dimesylate (LDX)...
May 15, 2017: Trends in Psychiatry and Psychotherapy
https://www.readbyqxmd.com/read/28494390/bipolar-patients-treated-with-long-acting-injectable-risperidone-in-taiwan-a-1-year-mirror-image-study-using-a-national-claims-database
#15
Ming H Hsieh, Po-Ya Chuang, Chi-Shin Wu, Ching-Jui Chang, Pei-Fang Chung, Chao-Hsiun Tang
OBJECTIVE: Bipolar disorder (BD) is burdensome for patients and healthcare systems. This study evaluated changes in concomitant medication patterns, healthcare utilization, and costs after the initiation of risperidone long-acting injection (RLAI) treatment among BD patients. METHOD: 287 BD patients receiving regular RLAI treatment for 1 year were identified from the Taiwan National Health Insurance Research database during 2007-2012. The bootstrapping procedure was performed to create 1000 samples to generate normally distributed data...
May 3, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28492454/use-of-lithium-in-severe-acute-manic-episodes-retrospective-prescription-practice-from-a-tertiary-inpatient-unit
#16
Armağan Özdemir, Cana Aksoy Poyraz, Burç Ç Poyraz, Nazife G Usta Sağlam, Semra Enginkaya, Nesrin Tomruk
OBJECTIVE: A retrospective chart review was performed to investigate the common preferences of clinicians for the pharmacological treatment of acute manic episodes, with particular regard to lithium use, and to assess the adherence of clinical practice to established guidelines. METHODS: Cases of manic episodes in patients admitted to Bakirköy Mazhar Osman Mental Health and Neurological Diseases Education and Research Hospital were retrospectively reviewed. Length of stay, medication data, serum levels, and adverse effects were evaluated for patients who received lithium therapy (N=98)...
May 2017: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/28480485/long-term-lithium-treatment-in-bipolar-disorder-effects-on-glomerular-filtration-rate-and-other-metabolic-parameters
#17
Leonardo Tondo, Maria Abramowicz, Martin Alda, Michael Bauer, Alberto Bocchetta, Lorenza Bolzani, Cynthia V Calkin, Caterina Chillotti, Diego Hidalgo-Mazzei, Mirko Manchia, Bruno Müller-Oerlinghausen, Andrea Murru, Giulio Perugi, Marco Pinna, Giuseppe Quaranta, Daniela Reginaldi, Andreas Reif, Philipp Ritter, Janusz K Rybakowski, David Saiger, Gabriele Sani, Valerio Selle, Thomas Stamm, Gustavo H Vázquez, Julia Veeh, Eduard Vieta, Ross J Baldessarini
BACKGROUND: Concerns about potential adverse effects of long-term exposure to lithium as a mood-stabilizing treatment notably include altered renal function. However, the incidence of severe renal dysfunction; rate of decline over time; effects of lithium dose, serum concentration, and duration of treatment; relative effects of lithium exposure vs. aging; and contributions of sex and other factors all remain unclear. METHODS: Accordingly, we acquired data from 12 collaborating international sites and 312 bipolar disorder patients (6142 person-years, 2669 assays) treated with lithium carbonate for 8-48 (mean 18) years and aged 20-89 (mean 56) years...
December 2017: International Journal of Bipolar Disorders
https://www.readbyqxmd.com/read/28475672/lithium-and-an-epac-specific-inhibitor-esi-09-synergistically-suppress-pancreatic-cancer-cell-proliferation-and-survival
#18
Xinshuo Wang, Cheng Luo, Xiaodong Cheng, Meiling Lu
Our previous studies showed that while lithium suppresses proliferation and induces apoptosis in pancreatic cancer cells, the inhibition of exchange proteins directly activated by cyclic adenosine monophosphate (cAMP) (EPAC)1 blocks pancreatic cancer cell migration and invasion. In this study, we further investigated the combinatory effects of lithium and EPAC-specific inhibitor (ESI)-09, an EPAC-specific inhibitor, on pancreatic cancer cell proliferation and viability, and explored whether lithium synergistically cooperates with EPAC inhibition in suppressing pancreatic cancer cell tumorigenicity...
May 5, 2017: Acta Biochimica et Biophysica Sinica
https://www.readbyqxmd.com/read/28474733/practitioner-review-the-effects-of-atypical-antipsychotics-and-mood-stabilisers-in-the-treatment-of-depressive-symptoms-in-paediatric-bipolar-disorder
#19
REVIEW
Tobias Atkin, Nicolas Nuñez, Gabriella Gobbi
BACKGROUND: The management of depressive and mixed symptoms in children and adolescents with bipolar disorder (BD) remains a matter of debate. The goal of this review is, thus, to systematically examine the impact of atypical antipsychotics (AAPs) and mood stabilisers in the treatment of bipolar depression and/or mixed states. METHODS: A literature search was conducted for studies assessing the efficacy of pharmacological treatments for bipolar disorder type I, type II and not otherwise specified with a recent depressive, mixed or manic episode (with depressive symptoms) following DSM-IV criteria in children and adolescents as either acute or maintenance treatment...
May 5, 2017: Journal of Child Psychology and Psychiatry, and Allied Disciplines
https://www.readbyqxmd.com/read/28461248/simultaneous-triple-therapy-for-the-treatment-of-status-epilepticus
#20
Jerome Niquet, Roger Baldwin, Keith Norman, Lucie Suchomelova, Lucille Lumley, Claude G Wasterlain
Early maladaptive internalization of synaptic GABAA receptors (GABAAR) and externalization of NMDA receptors (NMDAR) may explain the time-dependent loss of potency of standard anti-epileptic drugs (AED) in refractory status epilepticus (SE). We hypothesized that correcting the effects of changes in GABAAR and NMDAR would terminate SE, even when treatment is delayed 40 minutes. SE was induced in adult Sprague-Dawley rats with a high dose of lithium and pilocarpine. The GABAAR agonist midazolam, the NMDAR antagonist ketamine and the AED valproate were injected 40 min after SE onset in combination or as monotherapy...
April 29, 2017: Neurobiology of Disease
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