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On the Significance of the Erythrocyte Lithium to Plasma Lithium Ratio

  • James L. Marini (a1)


Correlations between the ratio of erythrocyte to plasma lithium (Le/Lp) and clinical status have been reported by some authors and disputed by others. Examination of the literature on Le/Lp and erythrocyte physiology suggests that Le/Lp is determined by peripheral pharmacokinetic parameters and has no direct relationship to central pathophysiology. Because of this, and because of inconsistencies between studies reporting correlations of the ratio with clinical status, such correlations probably cannot illuminate either the pathophysiology of affective illness or the mode of action of lithium.



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Amdisen, A. (1975) Monitoring of lithium treatment through determination of lithium concentrations. Danish Medical Bulletin, 22, 277–91.
Elizur, A., Shopsin, B., Gershon, S. & Ehlenberger, A. (1972) Intra: extra cellular lithium ratios and clinical course in affective states. Clinical Pharmacology and Therapeutics, 13, 947–52.
Frazer, A., Mendels, J., Secunda, S. K., Cochrane, C. M. & Bianchi, C. P. (1973) The prediction of brain lithium concentrations from plasma or erythrocyte measures. Journal of Psychiatric Research, 10, 17.
Garrahan, P. J. (1970) in Bittar, E. E. (ed.), Membranes and Ion Transport London: Wiley-Interscience. Vol 2, pp 185215.
Lassen, V. V. & Sten-Knudsen, O. (1968) Direct measurements of membrane potential and membrane resistance of human red cells. The Journal of Physiology (London), 195, 681–96.
Latimer, W. M. (1952) Oxidation Potentials, Englewood Cliffs, New Jersey: Prentice-Hall.
Lee, C. R., Hill, S. E., Dimitrakoudi, M., Jenner, F. A. & Pollit, R. J. (1975) The relationship of plasma to erythrocyte lithium levels in patients taking lithium carbonate. British Journal of Psychiatry, 127, 596–8.
Lyttkens, L., Soderberg, U. & Wetterberg, L. (1973) Increased lithium erythrocyte/plasma ratio in manic depressive psychosis. Lancet, i, 40.
Maizels, M. (1968) Effect of sodium content on sodium efflux from human red cells suspended in sodium-free media containing potassium, rubidium, caesium or lithium chloride. The Journal of Physiology (London), 195, 657–79.
MoConaghey, P. D. & Maizels, M. (1962) Cation exchanges of lactose-treated human red cells. The Journal of Psysiology (London), 162, 485509.
Mendels, J. & Frazer, A. (1973) Intracellular lithium concentration and clinical response: towards a membrane theory of depression. Journal of Psychiatric Research, 10, 918.
Rybakowski, J., Chlopocka, M., Kapelski, Z., Hernacka, B., Szajnerman, Z. & Kasprzak, K. (1974) Red blood cell lithium index in patients with affective disorders in the course of lithium prophylaxis. International Pharmaco-psychiatry, 9, 166–71.
Soucek, K., Zvolsky, P., Kralik, R., Filip, V., Vlnarova, E. & Dostal, T. (1974) The levels of lithium in serum and red blood cells and its ratios in manic-depressive patients. Activitas Nervosa Superior (Praha) 16, 193–5.
Thomas, R. C., Simon, W. & Oehme, M. (1975) Lithium accumulation by snail neurones measured by a new Li+ sensitive microelectrode. Nature 258, 754–6.
Wespi, H. H. (1969) Active transport and passive fluxes of K, Na and Li in mammalian non-myelinated nerve fibers. Pfluger's Archiv, 306, 262–80.
Worrall, E. P., Moody, J. P. & Naylor, G. J. (1975) Lithium in non-manic-depressives: antiaggressive effect and red blood cell lithium values. British Journal of Psychiatry, 126, 464–8.
Zakowska-Dabrowska, T. & Rybakowski, J. (1973) Lithium-induced EEG changes: relation to lithium levels in serum and red blood cells. Acta Psychiatrica Scandinavica, 49, 457–65.

On the Significance of the Erythrocyte Lithium to Plasma Lithium Ratio

  • James L. Marini (a1)


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On the Significance of the Erythrocyte Lithium to Plasma Lithium Ratio

  • James L. Marini (a1)
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