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Original Article |
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Neuropsychopharmacology (1998) 19 200-205.10.1038/sj.npp.1395203
Lithium¾Early Development, Toxicity, and Renal Function
Gordon Johnson MB, BS, FRANZCP, FRCPsych, DPM |
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Department of Psychological Medicine, The University of Sydney, Sydney, New South Wales, and Mood Disorder Unit, Northside Clinic, Greenwich, New South Wales, Australia
Correspondence: Dr Gordon Johson, Room 4, University of Sydney Clinical Science Building, Repatriation General Hospital, Hospital Road, Concord, 2139, NSW, Australia
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ABSTRACT
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The report of the effectiveness of lithium in the treatment of mania by John Cade was followed by a number of studies confirming his observations and developing guidelines for safe and effective use. Premature rejection of lithium on safety grounds denied many patients the benefit of treatment and may have cost more lives than it saved. A similar safety alarm was triggered by reports of kidney damage in the late 1970s. Subsequent reports have questioned the significance of anatomical findings, and functional impairment and relationship to lithium treatment. Recent findings support the conclusion that progressive impairment of glomerular and tubular function in patients during lithium maintenance is the exception rather than the rule and is related more to lithium intoxication, maintenance plasma lithium levels, concurrent medications, somatic illness, and age than on time on lithium. Guidelines for lithium use and monitoring of renal function are outlined.
Keywords: Lithium; Mania; Early development; Toxicity; Renal function |
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