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Aspirin and lithium


Is aspirin useful in patients on lithium? A pharmacoepidemiological study related to bipolar disorder

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Is aspirin useful in patients on lithium? A pharmacoepidemiological study related to bipolar disorder

. 2010 Jan;82(1):9-14.

doi: 10.1016/j.plefa.2009.10.007. Epub 2009 Nov 25.

Pieter Stolk  1 , Patrick C Souverein, Ingeborg Wilting, Hubert G M Leufkens, Donald F Klein, Stanley I Rapoport, Eibert R Heerdink

Affiliations

Affiliation

  • 1 Division of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, Netherlands.
  • PMID: 19939659
  • PMCID: PMC2818404
  • DOI: 10. 1016/j.plefa.2009.10.007

Free PMC article

Pieter Stolk et al. Prostaglandins Leukot Essent Fatty Acids. 2010 Jan.

Free PMC article

. 2010 Jan;82(1):9-14.

doi: 10.1016/j.plefa.2009.10.007. Epub 2009 Nov 25.

Authors

Pieter Stolk  1 , Patrick C Souverein, Ingeborg Wilting, Hubert G M Leufkens, Donald F Klein, Stanley I Rapoport, Eibert R Heerdink

Affiliation

  • 1 Division of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, Netherlands.
  • PMID: 19939659
  • PMCID: PMC2818404
  • DOI: 10.1016/j.plefa.2009.10.007

Abstract

Objectives: Administration to rats of mood stabilizers approved for bipolar disorder (BD) downregulates markers of the brain arachidonic acid (AA, 20:4n-6) metabolic cascade, including phospholipase A(2) (PLA(2)) and cyclooxygenase (COX) expression. We hypothesized that other agents that target the brain AA cascade, nonsteroidal anti-inflammatory drugs (NSAIDs) and glucocorticoids, also would ameliorate BD symptoms.

Methods: Medication histories on subjects who had been prescribed lithium were collected from the Netherlands PHARMO Record Linkage System. Data were stratified according to drug classes that inhibit PLA(2) and/or COX enzymes, and duration of use. Incidence density (ID) of medication events (dose increase or substance change) was used as a proxy for clinical worsening. ID ratios in patients with the inhibitors plus lithium were compared to ratios in patients using lithium alone.

Results: Low-dose acetylsalicylic acid (aspirin) significantly reduced the ID ratio of medication events, independent of use duration. The ID ratios of NSAIDs and glucocorticoids did not differ significantly from 1.0 if prescribed for > or =180 or > or =90 days, but exceeded 1.0 with shorter use. Selective COX-2 inhibitors had no significant effect and multiagent administration increased the ID ratio above 1.0.

Conclusions: Low-dose aspirin produced a statistically significant duration-independent reduction in the relative risk of clinical deterioration in subjects on lithium, whereas other NSAIDs and glucocorticoids did not. These tentative findings could be tested on larger databases containing detailed information about diagnosis and disease course, as well as by controlled clinical trials.

Published by Elsevier Ltd.

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  • Z01 AG000145-07/ImNIH/Intramural NIH HHS/United States
  • Z01 AG000428-02/ImNIH/Intramural NIH HHS/United States

Lithium in urine with a 30% discount at the Lab4U laboratory in Moscow

Analysis description

Determining the level of lithium in the urine is indicated for:

  • assessment of lithium balance in the treatment of lithium-containing drugs;
  • for diagnosing the toxic effects of lithium (weakness, slurred speech, nausea, vomiting, diarrhea).

Every 3 months it is necessary to control the concentration of lithium 12 hours after taking the drug.

Research method - Atomic absorption spectrometry

Research material — Single urine

Deadline

The analysis will be ready in within 5 days, excluding Saturday, Sunday and the day of collection. The term can be extended by 1 day if necessary. You will receive results by email. email as soon as it's ready.

Deadline: within 5 days, excluding Saturday, Sunday and the day of sampling, excluding Saturday and Sunday (except for the day of taking the biomaterial)

How to prepare

In advance

To donate feces and urine to the laboratory, purchase sterile 60 ml disposable containers in advance at the pharmacy or get them free of charge from the medical center. Sign your full name and order number on the containers.

Discuss with your doctor the possibility of canceling the drugs you are taking (it is recommended to cancel 24 hours before the urine test - diuretics, B vitamins, furagin, aspirin).


On the day of delivery

How to collect urine:
  • perform external genital hygiene before collecting urine,
  • Collect all morning urine in a clean, dry container,
  • mix and collect 10-20 ml of urine into a sterile container,
  • screw cap tightly,
  • Store the container of urine in the refrigerator and hand it over to the medical center on the day of collection.
  • Women are advised not to collect urine during menstrual bleeding.

Explanation

Interpretation of test results is for informational purposes only and is not a diagnosis or replaces medical advice. Reference values ​​may differ from those indicated in depending on the equipment used, the actual values ​​will be indicated on the form results.

Lithium in urine

The content of lithium in soil and water in different regions varies. Preparations containing lithium are widely used in psychiatry. It is a slow-acting drug that affects mood. The dosage of the drug is selected individually for each patient. To avoid toxic effects, it is important to assess the level of lithium in the blood and in the urine. High concentrations of lithium can lead to clouding of consciousness, heart attacks, and even death.

Symptoms of lithium poisoning: abdominal pain, nausea, metallic taste in the mouth, thirst, polyuria, edema. Stop taking lithium and seek medical attention. The doctor will prescribe a urine test for lithium levels, a blood test for electrolytes, urea, creatinine.

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