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Effect of lithium citrate on adrenocortical activity in manic-depressive illness
Journal article   Peer reviewed

Effect of lithium citrate on adrenocortical activity in manic-depressive illness

Russell Noyes Jr, Irving C Ringdahl and N J C Andreasen
Comprehensive Psychiatry, Vol.12(4), pp.337-347
07/01/1971
DOI: 10.1016/0010-440X(71)90071-X
PMID: 5112605
url
https://doaj.org/article/36c2c35d4b0947fea1457b0c381557c7View
Open Access

Abstract

Twelve manic-depressive patients were treated with lithium citrate on a research ward where fluid and electrolyte intake was controlled. The following findings were noted:Four of the five depressed patients became symptom free as did all seven manic patients. The substitution of placebo during the symptom-free period was associated within 24–48 hr with recurrence of depressive or manic symptomatology in three manic and two depressed patients. In addition to its well established effect upon mania, lithium, in these cases, had a specific therapeutic effect upon depression as well.The introduction of lithium was associated with a temporary increase in 17-OHCS excretion along with an increased excretion of water, sodium, and potassium. These effects were not sustained, in some instances, beyond 24 hr. The substitution of placebo for lithium during the course of treatment resulted in changes in excretion which were in the opposite direction. The direction of the changes in steroid excretion suggests that lithium's effect upon electrolyte metabolism is not secondary to its action upon the adrenal cortex.Manic patients whowed a tendency to retain lithium while symptomatic and to excrete amounts in excess of that administered after becoming symptom-free. This retention of lithium tended to differentiate the manic from the depressed patients.Manic patients treated with lithium showed a higher rate of 17-OHCS excretion after they had become symptom-free than before administration of lithium. This increase may have been secondary to clinical improvement or to retention of lithium. The depressed patients did not show this trend towards increased steroid excretion.
Mental Disorders Psychiatry behavioral disciplines and activities

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