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The Utility of a Single-Point Dosing Protocol for Predicting Steady-State Lithium Levels

Published online by Cambridge University Press:  29 January 2018

Paul J. Perry*
Affiliation:
University of Iowa, Iowa City. IA52242, USA
Bruce Alexander
Affiliation:
University of Iowa, Iowa City. IA52242, USA
Randall A. Prince
Affiliation:
University of Iowa, Iowa City. IA52242, USA
Frederick J. Dunner
Affiliation:
University of Iowa, Iowa City. IA52242, USA
*
Correspondence

Abstract

Two methods for predicting steady-state serum lithium level were compared prospectively in in-patients suffering from affective disorder. A single-point prospective administration model that required a single 24-hour serum lithium level, following a test dose produced statistically similar predictions of the observed steady-state lithium levels as did a model that required 12- and 36-hour levels. However, the latter two-point method produced significantly more accurate predictions from clinical interpretation. Although the two-point approach is preferable, the single-point method is clinically acceptable if its limitations of accuracy are taken into consideration.

Type
Papers
Copyright
Copyright © 1986 The Royal College of Psychiatrists 

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References

Caldwell, H. C., Westlake, W. J., Conner, S. M. & Flanagan, T. (1971) A pharmacokinetic analysis of lithium carbonate absorption from several formulations in man. Journal of Clinical Pharmacology, 11, 349–56.Google ScholarPubMed
Cooper, T. B., Bergner, P. E. E. & Simpson, G. M. (1973) The 24-hour serum lithium level as a prognosticator of dosage requirements. American Journal of Psychiatry, 130, 601–3.CrossRefGoogle ScholarPubMed
Gengo, F., Timko, J., D'Antonio, J., Ramsey, T. A., Frazer, A. & Mendels, J. (1980) Prediction of dosage of lithium carbonate: use of a standard predictive method. Journal of Clinical Psychiatry, 41, 319–21.Google ScholarPubMed
Gibaldi, M. & Perrier, D. (1975) Pharmacokinetics, New York: Marcel Dekker.Google Scholar
Hansen, J. L. (1968) The measurement of serum and urine lithium by atomic absorption spectrophotometry. American Journal of Medical Technology, 34, 625–33.Google ScholarPubMed
Hullin, R. P. (1979). Minimum effective plasma lithium levels for long-term preventive treatment of recurrent affective disorders. In Lithium: Controversies and Unresolved issues. (Cooper, T. B., Gershon, S., Kline, N. S., et al, eds). Amsterdam: Excerpta Medica.Google Scholar
Lauritsen, B. J., Mellerup, E. T., Plenge, P., Rasmussen, S., Vestergaard, P. & Schou, M. (1981). Serum lithium concentrations around the clock with different treatment regimens and the diurnal variation of the renal lithium clearance. Acta Psychiactrica Scandinavica, 64, 314–9.Google ScholarPubMed
Naiman, I. F., Muniz, C. E., Stewart, R. B. & Yost, R. L. (1981) Practicality of a lithium dosing guide. American Journal of Psychiatry, 138, 1369–71.Google ScholarPubMed
Perry, P. J. (1982). Lithium nephrotoxicity. Drug Intelligence and Clinical Pharmacy, 16, 740–4.CrossRefGoogle ScholarPubMed
Perry, P. J., Alexander, B., Dunner, F. J., Schoenwald, R. D., Pfohl, B, & Miller, D. (1982) Pharmacokinetic protocol for predicting serum lithium levels. Journal of Clinical Psychopharmacology, 2, 114–8.CrossRefGoogle ScholarPubMed
Perry, P. J., Prince, R. A., Alexander, B. & Dunner, F. J. (1983) Prediction of lithium maintenance doses using a single point prediction protocol. Journal of Clinical Psychopharmacology, 3, 13–7.CrossRefGoogle ScholarPubMed
Perry, P. J., Alexander, B., Prince, R. A. & Dunner, F. J. (1984) Prospective evaluation of two lithium maintenance dose schedules. Journal of Clinical Psychopharmacology, 4, 242–46.CrossRefGoogle ScholarPubMed
Sheiner, L. B. & Beal, S. L. (1981) Some suggestions for measuring predictive performance. J. Pharmacokinet Biopharm, 9, 503512.CrossRefGoogle ScholarPubMed
Slattery, J. C., Gibaldi, M. & Koup, J. R. (1980) Prediction of maintenance dose required to attain a desired drug concentration at a steady state from a single determination of concentration after an initial dose. Clinical Pharmacokinetics, 5, 377–85.CrossRefGoogle Scholar
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