بررسي رابطه عوارض عصبي با غلظت پلاسمايي و داخل گلبولي ليتيم در بيماران مبتلا به اختلال دوقطبي

A study on the relationship between neurological side effects and lithium concentration in plasma and red blood cells in patients with bipolar I disorder

Introduction: Lithium as a first choice drug for controlling the acute phase of mania is widely used and relatively safe, but it has a major drawback which is the occasional of adverse effects in some patients with even low plasma concentrations. Therefore, there is an increasing need, for a precise method able to predict the accuracy of adverse effects. Methods: This descriptive- analytic study was undertaken on a group of patients with bipolar I disorder (manic phase). The relationship between lithium induced adverse effects and three laboratory indices were assessed; the indices included plasma lithium concentration, lithium concentration in red blood cells (RBCs) and the RBC/ plasma concentration ratio. Changes in Extrapyramidal Symptoms Rating Scale (ESRS), Abnormal Involuntary Movement Scale (AIMS) and Mini Mental Status Examination (MMSE) scores and clinical evaluation of tandem walk, rapid alternative movement, tremor, myoclonus and muscle force were considered as measures. for adverse effects. After six weeks of treatment the association of each adverse effect with lithium concentrations was assessed using statistical tests. Results: The findings show that adverse effects such as dystonia, dyskinesia, and cerebellar signs were correlated. Conclusion: Measurement of lithium concentration in RBC.s, could be of value in prediction of some neurological adverse effects of lithium.