Skip to main content
NCBI home page
British Journal of Clinical Pharmacology logoLink to British Journal of Clinical Pharmacology
. 1977 Apr;4(2):201–205. doi: 10.1111/j.1365-2125.1977.tb00694.x

Age as a factor affecting lithium therapy.

D S Hewick, P Newbury, S Hopwood, G Naylor, J Moody
PMCID: PMC1429021  PMID: 861133

Abstract

1 We examined the case notes of 82 psychiatric out-patients (aged 21-84 years) receiving lithium prophylaxis and with steady-state plasma lithium levels. 2 The mean weight-related daily dose of lithium prescribed decreased by about 50% between the third and eight decades. 3 The corresponding steady-state plasma lithium levels showed a less marked tendency to decrease, this only being seen in the seventh and eighth decades. 4 In patients aged 50 years or over the daily lithium dose required to give a plasma level of 1 mmol l-1 (0.50 mmol kg-1) was significantly lower than that (0.65 mmol kg-1) in patients aged under 50 years (P less than 0¿5, Student's t-test). In patients aged 70-79 years this dose was 31% lower than in patients under 50 years. However, interindividual variation was great and it was estimated that age only contributed about 14% to the total interpatient variation. 5 Of the 36 patients under 50 years of age, 42% had minor lithium side-effects and 17% were not optimally controlled with lithium. The corresponding figures for the 46 'older' patients were 46% and 28%. 6 Generally the 50% dosage reduction seemed necessary to compensate for an age-related decrease in lithium excretion and to reduce lithium side effects to a level comparable to that acceptable in younger patients.

Full text

PDF
201

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Coppen A., Peet M., Bailey J., Noguera R., Burns B. H., Swani M. S., Maggs R., Gardner R. Double-blind and open prospective studies on lithium prophylaxis in affective disorders. Psychiatr Neurol Neurochir. 1973 Nov-Dec;76(6):501–510. [PubMed] [Google Scholar]
  2. DAVIES D. F., SHOCK N. W. Age changes in glomerular filtration rate, effective renal plasma flow, and tubular excretory capacity in adult males. J Clin Invest. 1950 May;29(5):496–507. doi: 10.1172/JCI102286. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Ellis D. D., Greene R. J. Recording lithium therapy. Lancet. 1973 Mar 31;1(7805):719–719. doi: 10.1016/s0140-6736(73)91501-8. [DOI] [PubMed] [Google Scholar]
  4. Ewy G. A., Kapadia G. G., Yao L., Lullin M., Marcus F. I. Digoxin metabolism in the elderly. Circulation. 1969 Apr;39(4):449–453. doi: 10.1161/01.cir.39.4.449. [DOI] [PubMed] [Google Scholar]
  5. Fyrö B., Petterson U., Sedvall G. Pharmacokinetics of lithium in manic-depressive patients. Acta Psychiatr Scand. 1973;49(3):237–247. doi: 10.1111/j.1600-0447.1973.tb04417.x. [DOI] [PubMed] [Google Scholar]
  6. Hansen J. M., Kampmann J., Laursen H. Renal excretion of drugs in the elderly. Lancet. 1970 May 30;1(7657):1170–1170. doi: 10.1016/s0140-6736(70)91236-5. [DOI] [PubMed] [Google Scholar]
  7. Houghton G. W., Richens A., Leighton M. Effect of age, height, weight and sex on serum phenytoin concentration in epileptic patients. Br J Clin Pharmacol. 1975 Jun;2(3):251–256. doi: 10.1111/j.1365-2125.1975.tb01583.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Kristensen M., Molholm H. J., Kampmann J., Lumholtz B., Siersbaek-Nielsen K. Letter: Drug elimination and renal function. J Clin Pharmacol. 1974 May-Jun;14(5-6):307–308. doi: 10.1002/j.1552-4604.1974.tb02319.x. [DOI] [PubMed] [Google Scholar]
  9. Lehmann K., Merten K. Die Elimination von Lithium in Abhängigkeit vom Lebensalter bei Gesunden und Niereninsuffizienten. Int J Clin Pharmacol. 1974 Dec;10(4):292–298. [PubMed] [Google Scholar]
  10. Schou M. Lithium in psychiatric therapy and prophylaxis. J Psychiatr Res. 1968 Jun;6(1):67–95. doi: 10.1016/0022-3956(68)90047-2. [DOI] [PubMed] [Google Scholar]
  11. Triggs E. J., Nation R. L., Long A., Ashley J. J. Pharmacokinetics in the elderly. Eur J Clin Pharmacol. 1975;8(1):55–62. doi: 10.1007/BF00616415. [DOI] [PubMed] [Google Scholar]
  12. Vestal R. E., Norris A. H., Tobin J. D., Cohen B. H., Shock N. W., Andres R. Antipyrine metabolism in man: influence of age, alcohol, caffeine, and smoking. Clin Pharmacol Ther. 1975 Oct;18(4):425–432. doi: 10.1002/cpt1975184425. [DOI] [PubMed] [Google Scholar]
  13. Watanabe S., Ishino H., Otsuki S. Double-blind comparison of lithium carbonate and imipramine in treatment of depression. Arch Gen Psychiatry. 1975 May;32(5):659–668. doi: 10.1001/archpsyc.1975.01760230125010. [DOI] [PubMed] [Google Scholar]

Articles from British Journal of Clinical Pharmacology are provided here courtesy of British Pharmacological Society

RESOURCES