The Structural and Functional Changes Indcuced By Lithium on The Renal Cortex of Growing Albino Rats: Ultrastructure and Laboratory Study.

Introduction: Lithium is a therapeutic agent currently used for the treatment of aff ective disorders controlling a variety of neurotic and psychosomatic manic depressions. Th e main objective of the present work was to demonstrate the histopathological eff ects of the therapeutic doses of Lithium on the renal tubules and glomeruli in growing albino rats. Material and Methods: Th irty growing male Sprague – Dawley albino rats were used in this study. Th e rats were divided into a control group formed of 6 rats and an experimental group formed of 24 rats which received a daily therapeutic dose of 20 mg Lithium/kg body weight by the same route for 7 weeks. Th e renal cortex in all animals is examined by light and electron microscopes. Blood was collected from the sacrifi ced animals for serum creatinine, urea, sodium and potassium to access the eff ect of lithium administration in a therapeutic dose on renal function. Results: Th e present work revealed that the therapeutic doses of Lithium induced nephrotoxicity in the form of degeneration and necrosis in the renal tubules and glomeruli. Alteration in the cellular fi ne structure and degenerated cytoplasm and cytoplasmic organelles were found revealing cellular degeneration and necrosis. Glomerulosclerosis and congestion were the predominant eff ect on the renal glomeruli. Conclusion: Histological and ultrastructrual features of Lithium nephrotoxicity were detected in the current study with therapeutic doses of Lithium.

L-arginine as a protective adjuvant in the treatment of bipolar disorders with hepatotoxic agent lithium

The purpose of this randomized experimental study was to explore the beneficial effects of L-arginine on lithium carbonate induced liver toxicity. This study is randomized, interventional, prospective and experimental in nature. This study was conducted in the department of anatomy, Basic medical sciences institute, Jinnah post graduate medical centre, Karachi. Animals were obtained from the animal house of BMSI, JPMC, Karachi. The duration of this study comprises of two to twelve weeks. Sixty albino adult rats of 90 - 120 days of age weighing about 200 - 300 grams were used for this study. These were divided into four major groups A,B, C and D each comprising 15 rats. Each major group was sub-divided into three sub-groups 1, 2 and 3 on the basis of 02 weeks, 6 weeks and 12 weeks duration of treatment respectively. 4 um thick sections of rat liver were cut using rotary microtome for H and E. The statistical significance of the differences of various quantitative changes between lithium carbonate and lithium carbonate + L-arginine treated rats from the control rats were evaluated by the student T-test. Lithium treated group exhibited significant augmentation in absolute and relative liver weight. Histopathological findings of liver revealed dilatation of central and portal veins, congestion of sinusoids, increment in mononuclear cell infiltration, microvesicular fatty change, swelling and hydropic degeneration of hepatocytes leading to pyknosis of nuclei, disintegration of organelles consequently leading to cell apoptosis and necrosis. Rats fed on co-administration of lithium plus L-arginine displayed significant improvement in the altered histology of liver lobules. This study revealed that concomitant administration of L-arginine with lithium considerably reduces lithium's adverse effects

Drogas psicotrópicas e coraçäo / Psychotropic drugs and the heart

A moderna Psicofarmacoterapia teve início na década de 1960 e revolucionou o tratamento das doenças mentais. De modo sucessivo e, principalmente no início, empírico, antidepressivos como o diazepam, além do lítio e da carbamazepina foram sendo lançados. Muitas dessas drogas, como os antidepressivos tricíclicos, provocam, mesmo em doses terapêuticas, importantes açöes cardiológicas; eles também interagem, farmacoldinâmica ou farmacocineticamente, com medicamentos usados em Cardiologia. Neste artigo, säo abordados os principais efeitos cardiológicos diretos ou indiretos dos psicofármacos usados na terapêutica psiquiátrica.

Developmental toxicity of lithium treatment at prophylactic levels

Lithium (Li+) salts are frequently used in psychiatry and may be administered to women in theirreproductive years. We have investigated the influence of chronic Li+ administration on rat offspring. Pregnant Wistar rats drank either tap water ad libitum or 10 mM LiCl, or were water restricted (paired to rats receiving LiCl) until pup weaning. Following birth, pups were fostered to form five experimetnal groups (N = numbers of litters): a) Control-S, stressed by water restriction (N = 21), b) Li+ during the prenatal and lactating periods (N=18),c) Li+ during the prenatal period only (N=22), d) Li+ during the lactating period only (N = 15), and e) Control-NS no treatment (N = 13). Prenatal water restriction of Li+ treatment impaired the performance of the righting reflex, altered the number of males born and delayed the final date of eye opening. Postnatal water restriction or Li+ treatment of the dams reduced body growth and the date of eye opening of pups. No difference was found in the time to pup earflap opening, or in the motor coordination test. The specific effect of lithium on pups included impairment of the righting reflex, an increase in the number of males born, a reduction in body weight at weaning and a delay in the eye opening date. The serum Li+ levels of the dams were maintained at approximately 0.5 mEq/l. Ther was an increase in serum potassium, but not sodium, concentrations. We conclude that chronic treatment of dams with Li+ in amounts similar to those used in the prophylaxis of bipolar disorders aggravated the delay in physical and behavioral development of pups produced by stress associated with limited water intake and handling

Lithium toxicity--a risk factor for neuroleptic malignant syndrome.

We report a case of neuroleptic malignant syndrome (NMS). Lithium toxicity might have predisposed to the development of the syndrome in our patient. The patient had hyperthermia, extrapyramidal rigidity, disturbance in autonomic function and raised serum CPK level.

Lítio e gravidez: revisäo de literatura / Lithium and pregnancy: review of the literature

Devido à possibilidade de teratogenicidade, o lítio deve ser usado durante o 1§ trimestre de gravidez somente se clinicamente imprescindível. Os níveis de lítio devem ser monitorizados durante a gravidez e a dosagem ajustada quando necessária. Quando for indispensável usar dieta hipossódica, isso deve ser feito com muita precauçäo. As máes em uso de lítio que decidem amamentar deve estar atentas para os sinais de intoxicaçäo em seus bebês. Deve ser levada em consideraçäo a possibilidade de gestaçäo toda vez que se prescreve lítio a mulheres no período reprodutivo

La utilización clinica del litio / Clinical utilization of lithium

Este tabajo actualiza algunos conocimientos farmacológicos y toxicológicos adquiridos en cuarenta años de utilización del litio en la terapéutica psiquiátrica. A pesar de la difusión relativamente reciente del litio, la experiencia ha permitido establecer lineamientos generales de su aplicación clínica; se revisa la metodología para una adecuada indicación y monitoreo del paciente tratado con litio