Behavioural and Biological Effects of Lithium in Affective Illness

Abstract

Attempts have been made to contribute to knowledge of clinical aspects of affective illnesses in the light of the effects of lithium ions on some patients. Small groups of patients have received in depth ideographic studies in a metabolic unit, and larger numbers have been studied in a trial of the possible potentiation of the effects of tranylcypromine by lithium. The results suggest a potentiation but do not prove it. Studies of lithium distribution in plasma and erythrocytes show that individual differences and intraindividual differences are too great to make the ratio a useful clinical measure. Studies of the E.E.G. essentially show that correlations with intracellular lithium are no better than with plasma lithium, though lithium does have a profound and persisting effect on the E.E.G. While in some patients catecholamine metabolism is altered in phase with changes in mood, and while lithium changes the mood and so the phases, there is little evidence of a direct effect of lithium on the excretion of 3-methoxy-4-hydroxyphenylethylene glycol, which is separable from changes in mood. Studies of lithium on antidiuretic activity of patients' body fluids suggest that it causes increased production of vasopressin, with paradoxical increased urine volume. This is consistent with the view that the renal effect of ADH is inhibited and the hypothalamus compensates; when compensation is inadequate a renal diabetes insipidus follows. The effects of lithium on glucose tolerance tests of patients was also considered and a significant tendency for decreases in glucose serum levels during the long-term administration of lithium to manic persons was demonstrated.