Decreased serum lithium during verapamil therapy.

American Heart Journal (Impact Factor: 4.56). 12/1984; 108(5):1378-80. DOI: 10.1016/0002-8703(84)90776-2
Source: PubMed
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    ABSTRACT: We examined red blood cell (RBC) and plasma lithium concentrations and RBC/plasma lithium ratios in 14 manic patients during lithium treatment as part of the National Institute of Mental Health's Collaborative Program on the Psychobiology of Depression, Biological Studies. All of the lithium measures increased during treament, especially RBC lithium. There were positive correlations between the RBC lithium concentration and the RBC/plasma lithium ratio and their maximal values in a single-dose pharmacokinetic experiment before treatment. After 5 and 16 days of treatment, patients with good subsequent outcome had higher RBC/plasma lithium ratios than did patients with poor outcome. Early in treatment, there was a negative correlation between lithium concentrations and severity of mania. During treatment, there was a negative correlation between RBC lithium and urinary MHPG excretion. There was a positive correlation between RBC or plasma lithium during the first few days of treatment and subsequent reduction in norepinephrine excertion during treatment. At 3 weeks, there were negative correlations between reductions in catecholamine measures and lithium concentrations. These data suggest that there are changes in the sensitivity of behavior and catecholamine function to lithium during treatment. RBC concentrations of lithium appear to be a potentially useful indicator of its behavioral and neurochemical effects.
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    ABSTRACT: Rat brain S-HT2 and dopamine2 receptors were assessed following a chronic (3 weeks) administration of verapamil, lithium, and a combination of these two drugs. A significant increase in the number of 5-HT2 receptors was observed in the frontal cortex after the verapamil treatment, but the lithium and combined treatment had no effect on the densities of either binding sites. These data suggest that one or more of the mechanisms of the antimanic effect of verapamil may be involved in the change in 5-HT2 binding sites in a manner that is different from that of lithium.
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    ABSTRACT: Calcium channel blockers (CCBs) inhibit the influx of calcium ions into excitable cells through long-acting (L-) channels. Four classes of CCBs have been synthesised, all with greater activity in hyperactive than in normal cells in diverse systems. Although more generally used for the treatment of cardiovascular disorders, CCBs have been shown to be effective in a number of psychiatric disorders. Verapamil, the most widely studied of the CCBs, has been found to be superior to placebo and equivalent to lithium in the treatment of mania. However, most trials have been small and no multi centre studies have been performed. CCBs may prevent antidepressant-induced mania and reduce the frequency of rapid cycling in bipolar disorder, and they may have applications in panic disorder. The antidepressant properties of CCBs remain to be clearly demonstrated. CCBs generally are well tolerated, but still experimental, alternatives to lithium and anticonvulsants in the treatment of bipolar mood disorders.
    CNS Drugs 07/1995; 4(1). · 4.38 Impact Factor