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Lithium dosing strategies during pregnancy and the postpartum period

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

DOI

  • Richard Wesseloo, Erasmus Medical Centre, Rotterdam, Holland
  • André I. Wierdsma, Erasmus Medical Centre, Rotterdam, Holland
  • Inge L. van Kamp, Leiden University, Holland
  • Trine Munk-Olsen
  • Witte J. G. Hoogendijk, Erasmus Medical Center, Rotterdam, the Netherlands., Holland
  • Steven A. Kushner, Erasmus Medical Centre, Rotterdam, Holland
  • Veerle Bergink

BackgroundLithium is challenging to dose during pregnancy.AimsTo provide guidance for dosing lithium during pregnancy.MethodRetrospective observational cohort study. Data on lithium blood level measurements (n = 1101), the daily lithium dose, dosing alterations/frequency and creatinine blood levels were obtained from 113 pregnancies of women receiving lithium treatment during pregnancy and the postpartum period.ResultsLithium blood levels decreased in the first trimester (-24%, 95% CI -15 to -35), reached a nadir in the second trimester (-36%, 95% CI -27 to -47), increased in the third trimester (-21%, 95% CI -13 to -30) and were still slightly increased postpartum (+9%, 95% CI +2 to +15). Delivery itself was not associated with an acute change in lithium and creatinine blood levels.ConclusionsWe recommend close monitoring of lithium blood levels until 34 weeks of pregnancy, then weekly until delivery and twice weekly for the first 2 weeks postpartum. We suggest creatinine blood levels are measured to monitor renal clearance.

OriginalsprogEngelsk
TidsskriftBritish Journal of Psychiatry
Vol/bind211
Nummer1
Sider (fra-til)31-36
Antal sider6
ISSN0007-1250
DOI
StatusUdgivet - jul. 2017

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