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Re: Lithium and Kidney

Posted by William Braden on November 28, 1998, at 20:28:44

In reply to Lithium and Kidney, posted by Hharold Mountain on November 22, 1998, at 8:55:58

> I have a patient who has had a LOT of trouble for many years with severe OCD + bipolar mood disorder. There has been marginally acceptable control with Lithium + venlafaxine. We have also tried carbamazapine and everything else I can think of. Currently, he is taking Epival + venlafaxine with fair control of OCD but fairly troublesome hopomania because his kidney function has come up at 50% of normal. The kidney Docs dont want him to take lithium anymore. What are the chances that this is related to lithium? I dont want to kill his kidneys but he is having LOTS of trouble. I will add gabapentin as soon as I get appproval from the Province. I wish we could go back to lithium + valproate with some assurance that this wont damage kidney. (His Lithium levels have never been excessive)
> Any help?
Studies show that lithium usually doesn't harm the kidney, but there's
always the chance that it harms, say, one per cent.
Besides, if his kidneys continue to fail, there is a chance of
sudden lithium toxicity.
Too bad, though, nothing really substitutes for the lithium.




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