Lithium And The Kidney - Is One Daily Dose Better Than 2

Lithium is used in psychiatry both to treat manic episodes and to prophylax against mood swings in bipolar manic-depressive disorders. Lithium is still the only drug known with this latter, prophylactic, property, and the number of patients in ongoing lithium therapy is, therefore, very large. Since lithium is administered to patients for years, it is important that it be given in a way which leads to the best psychotropic effect with a minimum of side effects. This has been achieved in most psychiatric clinics by giving lithium in divided doses as a slow-release preparation. In recent years, however, results have shown that this may not be the best administration schedule, since evidence suggests that fewer renal side effects may be produced if lithium is given once daily (in the evening) in conventional lithium carbonate tablets. In this article, it is hypothesized that the therapeutic effect of lithium against mood swings is preserved, with fewer side effects, if lithium is given with larger intervals between doses, (e.g., every second or third day), provided that the drug is administered in such a way as to produce therapeutic lithium concentrations lasting for ten to 15 hours after each lithium intake. An administration schedule for this new method of lithium therapy is described.