Lithium Dosing and Serum Concentrations Across the Age Spectrum

From Early Adulthood to the Tenth Decade of Life

Soham Rej, Serge Beaulieu, Marilyn Segal, Nancy C P Low, I. Mucsi, Christina Holcroft, Kenneth Shulman, Karl J. Looper

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Objectives: Little is known about how lithium should be dosed to achieve therapeutic but safe serum concentrations in older adults. In this paper, we investigate how the lithium dose–concentration ratio changes across the lifespan.

Methods: This was a cross-sectional analysis of 63 current lithium users aged 20–95 years using data from McGLIDICS (the McGill Geriatric Lithium-Induced Diabetes Insipidus Clinical Study). Participants underwent blood and urine tests, including serum lithium concentrations. Multivariate analyses were conducted to evaluate potential correlates of the lithium dose–concentration ratio.

Results: We found that between the ages of 40–95 years, the total daily dose of lithium required to achieve a given serum concentration decreases threefold (500 vs. 1,500 mg for 1.0 mmol/L). Greater age, once-daily dosing, and lower renal function (estimated glomerular filtration rate) were independently associated with a lower lithium dose–concentration ratio.

Conclusions: The lithium dose required to achieve a given serum lithium concentration decreases threefold from middle to old age, with this trend continuing into the ninth and tenth decades of life. In order to avoid lithium toxicity in aging patients, continued serum concentration monitoring and judicious dose reduction may be required, particularly in those patients with reduced renal function.

Original languageEnglish
Pages (from-to)911-916
Number of pages6
JournalDrugs and Aging
Volume31
Issue number12
DOIs
Publication statusPublished - Nov 25 2014

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Lithium
Serum
Kidney
Diabetes Insipidus
Hematologic Tests
Glomerular Filtration Rate
Geriatrics
Multivariate Analysis
Cross-Sectional Studies
Urine

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Geriatrics and Gerontology
  • Medicine(all)

Cite this

Lithium Dosing and Serum Concentrations Across the Age Spectrum : From Early Adulthood to the Tenth Decade of Life. / Rej, Soham; Beaulieu, Serge; Segal, Marilyn; Low, Nancy C P; Mucsi, I.; Holcroft, Christina; Shulman, Kenneth; Looper, Karl J.

In: Drugs and Aging, Vol. 31, No. 12, 25.11.2014, p. 911-916.

Research output: Contribution to journalArticle

Rej, S, Beaulieu, S, Segal, M, Low, NCP, Mucsi, I, Holcroft, C, Shulman, K & Looper, KJ 2014, 'Lithium Dosing and Serum Concentrations Across the Age Spectrum: From Early Adulthood to the Tenth Decade of Life', Drugs and Aging, vol. 31, no. 12, pp. 911-916. https://doi.org/10.1007/s40266-014-0221-1
Rej, Soham ; Beaulieu, Serge ; Segal, Marilyn ; Low, Nancy C P ; Mucsi, I. ; Holcroft, Christina ; Shulman, Kenneth ; Looper, Karl J. / Lithium Dosing and Serum Concentrations Across the Age Spectrum : From Early Adulthood to the Tenth Decade of Life. In: Drugs and Aging. 2014 ; Vol. 31, No. 12. pp. 911-916.
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