Hostname: page-component-7479d7b7d-jwnkl Total loading time: 0 Render date: 2024-07-16T02:58:30.874Z Has data issue: false hasContentIssue false
  • English
  • Français

The effect of digoxin on the response to lithium therapy in mania

Published online by Cambridge University Press:  09 July 2009

Catherine A. Chambers ,
Anne H. W. Smith  and
Graham J. Naylor
Catherine A. Chambers*
Affiliation:
Royal Dundee Luff Hospital, Dundee
Anne H. W. Smith
Affiliation:
Royal Dundee Luff Hospital, Dundee
Graham J. Naylor
Affiliation:
Royal Dundee Luff Hospital, Dundee
*
1Address for correspondence: Dr C. A. Chambers, Senior Registrar, Royal Dundee Liff Hospital, Dundee DD2 5NF.
Get access Rights & Permissions [Opens in a new window]

Synopsis

Patients suffering from manic-depressive psychosis, manic type (ICD 296·0), were treated with lithium carbonate and randomly allocated to two groups, one received digoxin and the other matching placebo for 7 days. Severity of mania was rated by psychiatrists on the Manic Rating Scale and Analogue Line on days 0 and 7 and by nurses daily on the Hargreaves Rating Scale, Psychotic Rating. Fourteen patients received digoxin and lithium carbonate and 14 patients received placebo and lithium carbonate. Improvement in the placebo lithium group was significantly greater than that in the digoxin lithium group. This trial suggests, therefore, that the effect of inhibition of membrane cation carrier is to reduce the response to lithium. This result is in keeping with our hypothesis that an increase in Na–K ATPase is essential to the therapeutic effect of lithium carbonate. It does not, however, exclude the possibility that the observations resulted from the inhibition by digoxin of lithium entry into the brain.

Type
Research Article
Information
Psychological Medicine , Volume 12 , Issue 1 , February 1982 , pp. 57 - 60
Copyright
Copyright © Cambridge University Press 1982

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Beigel, A., Murphy, D. L. & Bunney, W. E. Jr (1971). The Manic Rating Scale. Archives of General Psychiatry 25, 257–262.Google Scholar
Bertler, A., Anderrsonn, K.-E. & Wettrell, G. (1973). Concentration of digoxin in choroid plexus (Letter). Lancet ii, 1453.CrossRefGoogle Scholar
Doherty, J. E., Perkins, W. H. & Flanigan, W. J. (1967). The distribution and concentration of tritiated digoxin in human tissues. Annals of Internal Medicine 66, 116–124.CrossRefGoogle ScholarPubMed
Gillis, R. A., Peale, D. L. & Levitt, B. (1975). Digitalis: a neuro-excitatory drug. Circulation 52, 739–742.CrossRefGoogle Scholar
Glen, A. I. M. (1978). Lithium regulation of membrane ATP-ases. In Lithium in Medical Practice (ed. Johnson, F. N. and Johnson, S.), pp. 183–192. MTP Press: Lancaster.Google Scholar
Hargreaves, W. A. (1968). Systematic nursing observation of psychopathology. Archives of General Psychiatry 18, 518–531.CrossRefGoogle ScholarPubMed
Hokin-Naeverson, M., Speigel, D. A. & Lewis, W. C. (1974). Deficiency of erythrocyte sodium pump activity in bipolar manic-depressive psychosis. Life Sciences 15, 1739–1748.CrossRefGoogle Scholar
Krakauer, R. & Steiness, M. D. (1978). Digoxin concentration in choroid plexus, brain, and myocardium in old age. Clinical Pharmacological Therapeutics 24, 454–458.CrossRefGoogle ScholarPubMed
Lely, A. H. & Van Enter, C. H. J. (1970). Large scale digoxin intoxication. British Medical Journal iii, 737–740.CrossRefGoogle Scholar
Naylor, G. J., Dick, D. A. T., Dick, E. G. & Moody, J. P. (1974). Lithium therapy and erythrocyte membrane cation carrier. Psychopharmacologia 37, 81–86.CrossRefGoogle ScholarPubMed
Naylor, G. J., Worrall, E. P., Dick, P., Peet, M., Watson, Y. & Stewart, M. (1975). Trial of digoxin in mania. Lancet ii, 639–640.CrossRefGoogle Scholar
Naylor, G. J., Dick, D. A. T., Dick, E. G., Worrall, E. P., Peet, M., Dick, P. & Boardman, L. J. (1976). Erythrocyte membrane cation carrier in mania. Psychological Medicine 6, 659–663.CrossRefGoogle ScholarPubMed
Naylor, G. J., Smith, A., Boardman, L. J., Dick, D. A. T., Dick, E. G. & Dick, P. (1977). Lithium and erythrocyte membrane cation carrier studies in normal and manic-depressive subjects. Psychological Medicine 7, 229–233.CrossRefGoogle ScholarPubMed
Naylor, G. J., Smith, A. H. W., Dick, E. G., Dick, D. A. T., McHarg, A. M. & Chambers, C. A. (1980). Erythrocyte membrane cation carrier in manic-depressive psychosis. Psychological Medicine 10, 521–525.CrossRefGoogle ScholarPubMed
Shear, M. K. & Sacks, M. E. (1978). Digitalis delirium: report of two cases. American Journal of Psychiatry 135, 109–110.Google ScholarPubMed
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974). The Measurement and Classification of Psychiatric Symptoms. Cambridge University Press: Cambridge.Google Scholar
Wraae, O. (1978). The pharmacokinetics of lithium in the brain, cerebrospinal fluid and serum of rat. In Lithium in Medical Practice (ed. Johnson, F. N. and Johnson, S.), pp. 225–228. MTP Press: Lancaster.Google Scholar