Increased lithium dose requirement in a hyperglycemic patient

Monica Cyr, Melanie A.C. Guia, Steven Laizure

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

OBJECTIVE: To report a case of apparent increased lithium clearance in a patient with persistent hyperglycemia. METHODS: Lithium doses, blood glucose concentrations, and lithium plasma concentrations were evaluated in a patient during a 53-day inpatient admission for exacerbation of bipolar disorder. The lithium dose required to increase the lithium plasma concentration by 0.1 mEq/L was computed from the lithium dose and corresponding lithium plasma concentration. This value was correlated with the blood glucose concentration, RESULTS: A plot of the lithium dose required to increase the lithium plasma concentration by 0.1 mEq/L versus the blood glucose concentration exhibited a direct linear relationship (r2 = 0.62). This plot indicates that higher lithium doses are needed during hyperglycemic states compared with euglycemic states to achieve equivalent plasma concentrations. CONCLUSIONS: Glycosuria associated with hyperglycemia induces an osmotic diuresis that increases the renal clearance of lithium, necessitating higher lithium doses to maintain therapeutic lithium plasma concentrations.

Original languageEnglish (US)
Pages (from-to)427-429
Number of pages3
JournalAnnals of Pharmacotherapy
Volume36
Issue number3
DOIs
StatePublished - Jan 1 2002

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Lithium
Blood Glucose
Hyperglycemia
Glycosuria
Diuresis
Bipolar Disorder
Inpatients
Kidney

All Science Journal Classification (ASJC) codes

  • Pharmacology (medical)

Cite this

Increased lithium dose requirement in a hyperglycemic patient. / Cyr, Monica; Guia, Melanie A.C.; Laizure, Steven.

In: Annals of Pharmacotherapy, Vol. 36, No. 3, 01.01.2002, p. 427-429.

Research output: Contribution to journalArticle

Cyr, Monica ; Guia, Melanie A.C. ; Laizure, Steven. / Increased lithium dose requirement in a hyperglycemic patient. In: Annals of Pharmacotherapy. 2002 ; Vol. 36, No. 3. pp. 427-429.
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