Study of lithium concentration in saliva and plasma of Bipolar (mania) patients hospitalized at psychiatric ward of Ahwaz Golestan Hospital (Iran)

A. Ashnagar* and N. Sadeghi

School of Pharmacy, Ahwaz Jundi Shapour University of Medical Sciences, Ahwaz (Iran)

ABSTRACT: Lithium treatment is used to treat mania in bipolar disorder. Since taking blood samples from such patients are difficult, in this research for the first time in Iran, we decided to measure the concentration of lithium in other biological fluids such as saliva, as an alternative method for measuring lithium in blood samples. Lithium concentrations after 8-12 hours of the last oral doses in saliva and plasma of 33 manic patients hospitalized at Ahwaz Golestan Hospital (in Iran) under long-term lithium therapy were measured. Samples of saliva or blood were collected. The lithium concentrations of the samples were measured by using flame emission (photometry) technique. The mean blood lithium concentration was found to be (0.97±0.04) and the mean saliva lithium concentration was (2.22±0.06). On the basis of the results obtained in this research and on the basis of statistical calculations, the following equation was obtained: [Li]p=0.362[Li]s+0.166, where [Li]s=saliva lithium concentration and [Li]p=plasma lithium concentration. On the basis of this equation, salivary lithium concentration is always higher than plasma lithium concentration and the ratio between them is 2.29 and the correlation coefficient is 0.58 (P<0.01). The results obtained in this research demonstrate the possibility of using salivary lithium measurement for monitoring patients on prolonged therapy. Such method may help clinical laboratories to improve the TOM of lithium.

KEYWORDS: Mania; depression; bipolar; lithium; lithium carbonate; saliva; plasma

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