Pharmacopsychiatry 2012; 45(01): 1-6
DOI: 10.1055/s-0031-1286343
Original Paper
© Georg Thieme Verlag KG Stuttgart · New York

No Correlation between Lithium Serum Levels and Psychopathological Features during the Euthymic Interval of Patients with Recurrent Affective Disorder

U. Lewitzka
1  Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Dresden, Germany
3  Mood Disorder Research Clinic, IWK Health Centre, Halifax, Canada
,
R. Scheffczyk
2  Private Practice for Psychotherapy, Berlin, Germany
,
D. Ritter
1  Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Dresden, Germany
,
S. Doucette
3  Mood Disorder Research Clinic, IWK Health Centre, Halifax, Canada
,
M. Bauer
1  Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Dresden, Germany
,
T. Bschor
1  Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Dresden, Germany
4  Department of Psychiatry, Schlosspark-Clinic, Berlin, Germany
› Author Affiliations
Further Information

Publication History

received 10 April 2011
revised 04 July 2011

accepted 29 July 2011

Publication Date:
11 October 2011 (online)

Abstract

Introduction:

The aim of this prospective study was to investigate the influence of lithium serum levels on subclinical psychopathological features during the euthymic interval in patients with an affective disorder.

Methods:

The study included 54 patients with a recurrent affective disorder undergoing a continuous prophylactic lithium treatment (31 unipolar, 23 bipolar). The observation period lasted for 2 years and included 332 visits. Visits consisted of a detailed interview, a continuous measurement of lithium levels and the collection of validated scales including HAMD, YMRS, CGI, VAMS and the SCL-90R. Several correlations between lithium serum levels and different psychopathological features during the euthymic interval were calculated on an individual patient basis and on a group basis to reveal generally occurring correlations.

Results:

No generally occurring significant correlations between lithium serum levels and specific psychopathological features were found. Only on a single patient level, 32 significant correlations between lithium level and specific psychopathological features were found, partly indicating a negative and partly indicating a positive influence of higher lithium levels on psychopathological symptoms. Nevertheless, in the group analyses no significant correlations were found.

Discussion:

Higher lithium levels were not associated with an improved psychopathological status, but they were not associated with a worse status (due to a higher burden of side effects) either. According to the literature there is currently no strong evidence to treat patients with a higher lithium level. It is recommended to start with a lower level and to continue with individual adjustments in accordance to prophylactic efficacy and tolerability.