Supervising Lithium a Comparison of a Lithium Clinic, Psychiatric Out-patient Clinics, and General Practice

Supervision of lithium treatment among three groups of patients treated in different settings – at a lithium clinic, as hospital out-patients, and by a GP – was studied. The lithium clinic maintained lower levels and checked these more frequently. Elevated lithium levels were most frequent in the GP...

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Bibliographic Details
Published in:British journal of psychiatry 1988-04, Vol.152 (4), p.535-538
Main Authors: Masterton, George, Warner, Mary, Roxburgh, Brian
Format: Article
Language:English
Subjects:
Ambulatory Care
Biological and medical sciences
England
Family Practice
Female
Glomerular Filtration Rate
Humans
Kidney Glomerulus - physiopathology
Lithium - administration & dosage
Lithium - blood
Lithium - therapeutic use
Male
Medical sciences
Miscellaneous
Neuropharmacology
Pharmacology. Drug treatments
Time Factors
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Summary:Supervision of lithium treatment among three groups of patients treated in different settings – at a lithium clinic, as hospital out-patients, and by a GP – was studied. The lithium clinic maintained lower levels and checked these more frequently. Elevated lithium levels were most frequent in the GP-supervised group, which also included the 13 patients with the most impaired glomerular filtration. In hospital settings GFR-impaired patients received a lower daily dose of lithium; in general practice, affected patients had a higher mean serum lithium level and were more frequently prescribed lithium once daily. We conclude that patients with glomerular impairment who require lithium should be supervised by a specialist, or at least prescribed lithium in divided daily doses.
ISSN:0007-1250
1472-1465
DOI:10.1192/bjp.152.4.535