The top of the target range for lithium has been dropping for years and our
psychiatrists don't like long term maintenance levels going above 0.8mmol/L.
There is a paper from 1992 "Lithium therapy in practice" in Therapeutics
Update; Srinivasan D P and Birch N J. 1st September 1992 363 - 369. Which
states " The recommended lower plasma (sic) level of 0.4 - 0.8mmol/L makes
inadvertent toxicity much less likely" and Chapter 1, Clinical Aspects of
Lithium in Psychiatry by Mogens Schou in "Lithium and the Cell" ISBN
0-12-099300-7 1991, Academic Press; states that serum levels should be in
the order of 0.3 - 1.0mmol/L. These may be of some interest.
Paul Robinon
Royal berkshire Hospital
Reading.
-----Original Message-----
From: Les Culank
To: [log in to unmask]
Sent: 16/06/2003 10:35
Subject: Re: Lithium ref range
Dear Louise,
I'm old enough to remember when the serum Li range was up to 1.5, back
in the last century.
About 10+ years ago we were approached by our psychiatrists, who all
agreed on an upper limit of 1.0, except for the elderly they agreed on
up to 0.9. Sorry I don't still have any source data to hand, or EBM
references. I think it was a while ago the BNF changed to 0.4-1.0.
As for the lower end, they had long disagreed among themselves, but
didn't mind us quoting 0.4 mmol/l.
Best wishes,
Les
From: "Tilbrook Louise (RQ8) Mid Essex Hospital"
<[log in to unmask]>
Reply-To: "Tilbrook Louise (RQ8) Mid Essex Hospital"
<[log in to unmask]>
Date: Mon, 16 Jun 2003 10:10:55 +0100
To: [log in to unmask]
Subject: Lithium ref range
A colleague has pointed out that our quoted reference range for serum
lithium (0.5-1.2 mmol/L) differs from that in the BNF (0.4-1.0 mmol/L).
If anyone would be willing to share their lab reference range and its
source I would be very grateful.
Thanks
Louise Tilbrook
Louise Tilbrook
Principal Clinical Scientist
Mid Essex Hospital Services NHS Trust
Broomfield Hospital
Chelmsford
Essex
CM1 5ET
Phone 01245 514013
Fax 01245 514077
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