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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by linkadge on July 6, 2015, at 18:05:41
Can somebody explain the benefit (or lack thereof) of sublingual administration of a drug?
Does it result in a higher concentration of a drug?
Are only certain drugs capable of sublingual administration?
Does more of the drug reach the brain?
Is there a more direct blood pathway from under the tongue to the brain?
What I'm trying to determine, is whether lithium orotate would be absorbed sublingually, and whether it would result in increased brain levels of lithium (at least in theory).
Linkadge
Posted by Phillipa on July 6, 2015, at 20:58:03
In reply to subligual - different effects?, posted by linkadge on July 6, 2015, at 18:05:41
Don't know about lithium, but nitro glycerine is sublingual as it acts very quickly this way. This med effects the cardiovascular system. Phillipa
Posted by rjlockhart37 on July 6, 2015, at 23:35:42
In reply to subligual - different effects?, posted by linkadge on July 6, 2015, at 18:05:41
i've was given zyprexa [zydis] at a psych hospital when i signed myself in, it worked within seconds......maybe full effect in 3-5min.....
it absorbs through the tissue vessels under the tongue......it's not as fast as injection, but it works quickly
Posted by SLS on July 7, 2015, at 7:59:44
In reply to subligual - different effects?, posted by linkadge on July 6, 2015, at 18:05:41
> Can somebody explain the benefit (or lack thereof) of sublingual administration of a drug?
Some drugs become unstable when they are subject to the chemistry of the G.I. tract. They never have a chance to be absorbed intact. Allowing a drug to be administered parenterally (outside the G.I. tract) allows the drug to remain intact. Sublingual and buccal (inner cheeks) administrations are routes that can be used with some drugs. In addition - and no less important - is the fact that parenteral administration avoids first pass metabolism by the liver, thus preventing some drugs from becoming deactivated before they can circulate through the rest of the body.
> Does it result in a higher concentration of a drug?
I don't know if this is true of all drugs.
> Are only certain drugs capable of sublingual administration?
Certainly, a sublingual drug preparation must be compounded in a way that allows for efficient absorption through the mouth mucosa.
> Does more of the drug reach the brain?
I don't know. It might depend on the concentration of drug in the blood stream. If this is true, then, for some drugs, this is probably true. This is not true of all drugs, though. Drugs that dissolve poorly in water are more easily brought into the blood stream when a fatty meal is present in the G.I. tract. I believe Geodon and Latuda are examples of this.
> Is there a more direct blood pathway from under the tongue to the brain?
Yes. In that drugs that are absorbed from the G.I. tract are sent to the liver first increases the amount of time it takes for them to reach target tissues.
> What I'm trying to determine, is whether lithium orotate would be absorbed sublingually, and whether it would result in increased brain levels of lithium (at least in theory).
I don't think this would be true of lithium. In fact, it may be that it takes digestive substances to split the lithium ions from the orotate. I really don't know. In either case, lithium ion is not subject to first-pass metabolism. I think you can better meter the amount of lithium entering the blood stream by titrating through oral administration.
I hope someone can reply to your questions with more definitive information.
What are your reasons for wanting to take the orotate form of lithium ?
- Scott
Posted by linkadge on July 7, 2015, at 17:39:09
In reply to Re: subligual - different effects? » linkadge, posted by SLS on July 7, 2015, at 7:59:44
Thanks for this.
>What are your reasons for wanting to take the >orotate form of lithium ?
Basically my doctor doesn't want to try regular lithium as I am not "bipolar". He'd rather augment with another drug / antidepressant. I do well with ~75-150mg of lithium Carbonate. Lithium orotate doesn't seem to have an identical effect. I find it has a higher propensity to give me insomnia.
This is the end of the thread.
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