Lithium: The Forgotten Wonderdrug
Lithium: The Forgotten Wonderdrug
Lithium: The Forgotten Wonderdrug
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<strong>The</strong>rapeutic Levels<br />
• Upper end: 1.5 mEq/L<br />
– At 1.5 mEq/L the likelihood of achieving a response is<br />
outweighed by the possibility of toxicity<br />
• Lower end is a source of debate<br />
– Evidence exists that patients maintained between 0.4<br />
and 0.6 mEq/L were 2.6 times more likely to relapse<br />
than those between 0.8 and 1.0 mEq/L<br />
• Package inserts recommend between 0.6 and<br />
1.2 mEq/L concentrations<br />
Gelenberg AJ, Kane JM, Keller MB, Lavori P, Rosenbaum JF, Cole K, Lavelle J. Comparison<br />
of standard and low serum levels of lithium for maintenance treatment of bipolar disorder.<br />
N Engl J Med. 1989 Nov 30;321(22):1489-93.
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