Lithium in psychiatry

A Molecular Model for Lithium's Bioactive Form

Lithium carbonate, a drug for the treatment of bipolar disorder, provides mood stability to mitigate recurrent episodes of mania and/or depression. Despite its long-term and widespread use, the mechanism by which lithium acts to elicit these psychological changes has remained unknown. Using nuclear magnetic resonance (NMR) methods, in this study we characterized the association of lithium with adenosine triphosphate (ATP) and identified a bimetallic (Mg·Li) ATP complex. Lithium's affinity to form this complex was found to be relatively high (Kd ∼1.6 mM) compared with other monovalent cations and relevant, considering lithium dosing and physiological concentrations of Mg(2+) and ATP. The ATP·Mg·Li complex reveals, for the first time, to the best of our knowledge, that lithium can associate with magnesium-bound phosphate sites and then act to modulate purine receptor activity in neuronal cells, suggesting a molecular mode for in vivo lithium action.

The effect of lithium and related metal ions on the urinary excretion of 2-oxoglutarate and citrate in the rat

1 Administration of lithium ions to rats, either acutely by intraperitoneal injection or chronically in food, causes increased excretion of 2-oxoglutarate and citrate.2 Chronic administration in food of rubidium and caesium causes decreased excretion of 2-oxoglutarate and citrate.3 The effects described are not due to changes in urine volume, nor pH, nor are they simply related to the excretion of the injected ion.4 Acute administration of lithium caused an increased level of 2-oxoglutarate in kidney and reduced the ratio of glutamate to 2-oxoglutarate.5 Renal gluconeogenesis in slices was only slightly affected by either acute administration of lithium to the animals or by its presence in the incubation medium of renal slices.

Medical research council unit for metabolic studies in psychiatry, Sheffield

The Medical Research Council Unit for Metabolic Studies in Psychiatry was set up at Middle-wood Hospital, Sheffield, in 1967. It was to a considerable extent a continuation of the Medical Research Council Unit for the Chemical Pathology of Mental Disorders which had been associated with the Department of Physiology in the University of Birmingham under the direction of Professor I. E. Bush. The latter unit had in its turn largely corne from a group headed by Sir George Pickering at Oxford.

The distribution of lithium and its effects on the distribution and excretion of other ions in the rat

1. In rats, lithium (ca 1 mEquiv/kg body weight) decreased brain sodium and magnesium, bone sodium and calcium and increased muscle calcium, plasma magnesium, urinary calcium and urine volume.2. Lithium was particularly concentrated in bone.

The effect of lithium salts on the urinary excretion of -oxoglutarate in man

1. Lithium ions in therapeutic doses cause an increase in the renal excretion of alpha-oxoglutarate and glutaric acid.2. The excretion is probably due to reduced renal tubular reabsorption.3. Neither citrate, lactate nor pyruvate excretion rises.

Lithium-induced hyperpolarization of the human rectum in vivo

The transmucosal potential difference across the rectal mucosa was measured in 30 healthy subjects and in 13 psychiatric patients on lithium treatment for manic-depressive psychosis. It was significantly greater in the lithium-treated patients. A highly significant correlation was found between the potential difference and the serum lithium, and in all eight patients in whom it was measured before and one week after starting lithium treatment a rising potential difference was found. This phenomenon may possibly be explained in terms of resistance of the rectal mucosa to vasopressin.