Azizabadi-Farahani M, Mirazi N, Azar M, Farsam H, Dehpour A R
Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Iran.
J Clin Pharm Ther. 1996 Feb;21(1):3-7.
Patients treated with lithium (Li+) and neuroleptic drugs concomitantly are reported to show more pronounced adverse effects than patients on Li+ alone. There are conflicting results about the effect of neuroleptic drugs on the erythrocyte/plasma Li+ ratio and intraerythrocyte Li+ concentration, and methodological problems may be a reason for this. The effect of the concurrent use of neuroleptic drugs with Li+ on the Li+ ratio was studied in 66 patients with bipolar affective disorders during prophylactic Li+ therapy using the new direct method of measuring erythrocyte Li+ concentration. This new direct method has been shown to give much more precise and accurate results than the values obtained by other methods. No relationship was found between the Li+ ratio and sex, age, Li+ dosage, duration of treatment or plasma Li+ concentration. Results revealed that patients taking a combination of Li+ and neuroleptic drugs showed significantly lower Li+ ratios and intraerythrocyte Li+ concentrations as compared with those on Li+ alone. It is notable that this reducing effect of neuroleptic drugs was increased by the concurrent use of two types of neuroleptic drugs. The effect on neuroleptic drugs on the Li+ ratio may be mediated through a stabilizing effect of these drugs on the cell membrane and consequently Li+ transport in erythrocytes.
据报道，同时接受锂盐（Li+）和抗精神病药物治疗的患者比仅接受锂盐治疗的患者出现更明显的不良反应。关于抗精神病药物对红细胞/血浆Li+比值和红细胞内Li+浓度的影响，存在相互矛盾的结果，方法学问题可能是原因之一。在66例双相情感障碍患者进行锂盐预防性治疗期间，采用新的直接测量红细胞Li+浓度的方法，研究了抗精神病药物与Li+同时使用对Li+比值的影响。已证明这种新的直接方法比其他方法获得的值更精确、准确。未发现Li+比值与性别、年龄、Li+剂量、治疗持续时间或血浆Li+浓度之间存在关联。结果显示，与仅服用锂盐的患者相比，同时服用锂盐和抗精神病药物的患者Li+比值和红细胞内Li+浓度显著降低。值得注意的是，同时使用两种抗精神病药物会增强抗精神病药物对Li+比值的这种降低作用。抗精神病药物对Li+比值的影响可能是通过这些药物对细胞膜的稳定作用以及随后红细胞内Li+的转运来介导的。
