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1840 – Pharmacokinetics Of Lithium During Delivery And In The Neonatal Period. a Preliminary Data

Published online by Cambridge University Press:  15 April 2020

M. Guitart ,
M.L. Imaz ,
D. Soy ,
M. Torra ,
A. González-Rodríguez ,
S. Hernández ,
C. Hernández Rambla ,
C. Soler ,
A. Torres  and
L. Garcia-Esteve
M. Guitart
Affiliation:
Perinatal Psychiatry and Gender Research Program, Department of Psychiatry and Psychology, Institut Clínic of Neuroscience, Hospital Clínic, Barcelona, Spain Psychiatry, Xarxa Assistencial Althaia, Hospital Sant Joan de Déu, Manresa, Barcelona, Spain
M.L. Imaz
Affiliation:
Perinatal Psychiatry and Gender Research Program, Department of Psychiatry and Psychology, Institut Clínic of Neuroscience, Hospital Clínic, Barcelona, Spain Institut d’Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain
D. Soy
Affiliation:
Institut d’Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain Department of Pharmacy, Hospital Clínic, Barcelona, Spain
M. Torra
Affiliation:
Institut d’Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain Department of Biochemistry and Molecular Genetics, Biomedical Diagnostic Centre, Hospital Clinic, Barcelona, Spain
A. González-Rodríguez
Affiliation:
Perinatal Psychiatry and Gender Research Program, Department of Psychiatry and Psychology, Institut Clínic of Neuroscience, Hospital Clínic, Barcelona, Spain
S. Hernández
Affiliation:
Department of Maternal-Fetal Medicine, Institut Clínic of Gynaecology, Osbtetrics and Neonatology, Hospital Clínic, Barcelona, Spain
C. Hernández Rambla
Affiliation:
Psychiatry, University Hospital Parc Taulí, Barcelona, Spain
C. Soler
Affiliation:
Neonatology, Institut Clínic of Gynaecology, Obstetrics and Neonatology, Hospital Clínic, Barcelona, Spain
A. Torres
Affiliation:
Perinatal Psychiatry and Gender Research Program, Department of Psychiatry and Psychology, Institut Clínic of Neuroscience, Hospital Clínic, Barcelona, Spain Institut d’Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain
L. Garcia-Esteve
Affiliation:
Perinatal Psychiatry and Gender Research Program, Department of Psychiatry and Psychology, Institut Clínic of Neuroscience, Hospital Clínic, Barcelona, Spain Institut d’Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain

Abstract

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Introduction

Lithium has been used in the treatment of bipolar disorder in pregnant women. However, information on the pharmacokinetics of lithium during perinatal period is scarce.

Objectives

To study pharmacokinetics of lithium during delivery and in the neonatal period.

Methods

A prospective, observational and naturalistic study was conducted at the PERINATAL PSYCHIATRY PROGRAM CLÍNIC-BARCELONA, from 2005 to 2012. We included all consecutive cases of pregnant women with bipolar disorder I or II (n = 22), and on maintenance treatment with lithium monotherapy (n = 13) or polytherapy (n = 9) during pregnancy who elected artificial feeding. Lithium plasma concentrations in maternal blood and umbilical cord were detected. Lithium plasma concentrations in infants (n = 16) at delivery and in the neonatal period were obtained to calculate elimination half-life, which was estimated by lineal regression. Technique: AVL 9180 electrolyte analyser using a lithium-selective electrode (detection limit =0.10 mEq/L).

Results

Women did not fulfil diabetes criteria pre-pregnancy and during pregnancy. Attending to neonatal outcomes, infants exposed to polytherapy had a higher weight at birth (percentils) than those exposed to lithium alone [53.38 (33.40) vs. 70.22 (26.25)]. No statistically significant differences were found in umbilical cord:maternal plasma concentration ratio between those treated with lithium monotherapy and women treated with polytherapy (1.05 vs. 1.08). The lithium mean elimination half-life (SD) in infants was 6.73 (9.12) days.

Conclusions

Lithium crosses placental barrier almost completely. Elimination half-life in neonates exposed to lithium in utero was 6.73 days. Moreover, lithium treatment during pregnancy requires therapeutics monitoring in exposed dyads.

Type
Abstract
Information
European Psychiatry , Volume 28 , Issue S1: Abstracts of the 21th European Congress of Psychiatry , 2013 , 28-E1092
Copyright
Copyright © European Psychiatric Association 2013
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