Prediction Model of Serum Lithium Concentrations

Kazunari Yoshida, Hiroyuki Uchida, Takefumi Suzuki, Masahiro Watanabe, Nariyasu Yoshino, Hitoshi Houchi, Masaru Mimura, Noriyasu Fukuoka

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Introduction Therapeutic drug monitoring is necessary for lithium, but clinical application of several prediction strategies is still limited because of insufficient predictive accuracy. We herein proposed a suitable model, using creatinine clearance (CLcr)-based lithium clearance (Li-CL). Methods Patients receiving lithium provided the following information: serum lithium and creatinine concentrations, time of blood draw, dosing regimen, concomitant medications, and demographics. Li-CL was calculated as a daily dose per trough concentration for each subject, and the mean of Li-CL/CLcr was used to estimate Li-CL for another 30 subjects. Serum lithium concentrations at the time of sampling were estimated by 1-compartment model with Li-CL, fixed distribution volume (0.79 L/kg), and absorption rate (1.5/hour) in the 30 subjects. Results One hundred thirty-one samples from 82 subjects (44 men; mean±standard deviation age: 51.4±16.0 years; body weight: 64.6±13.8 kg; serum creatinine: 0.78±0.20 mg/dL; dose of lithium: 680.2±289.1 mg/day) were used to develop the pharmacokinetic model. The mean±standard deviation (95% confidence interval) of absolute error was 0.13±0.09 (0.10–0.16) mEq/L. Discussion Serum concentrations of lithium can be predicted from oral dosage with high precision, using our prediction model.

Original languageEnglish
JournalPharmacopsychiatry
DOIs
Publication statusAccepted/In press - 2017 Jul 13

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Keywords

  • lithium
  • prediction
  • therapeutic drug monitoring

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Pharmacology (medical)

Cite this

Yoshida, K., Uchida, H., Suzuki, T., Watanabe, M., Yoshino, N., Houchi, H., Mimura, M., & Fukuoka, N. (Accepted/In press). Prediction Model of Serum Lithium Concentrations. Pharmacopsychiatry. https://doi.org/10.1055/s-0043-116855