Abstract The safety of lithium carbonate, now in widespread use for treatment of manic-depressive disorders, has been questioned because of reports that it lowers the seizure threshold in patients prone to convulsive disorders. Seventeen state hospital patients were studied. Fifteen were severe epileptics, poorly controlled clinically with standard anticonvulsants and one had been well controlled; one patient had an abnormal electroencephalogram with no clinical history of seizure activity. All were administered lithium carbonate for a six-week period. EEGs were obtained prior to the study and twice weekly during the study. Serum lithium ion levels were determined prior to each EEG during the study period and maintained between 0.6 and 1.25 mEq/liter. There was only one instance of increased clinical seizure activity, while ten of the 16 seizure patients showed a clear reduction of seizure frequency. EEG changes paralleled clinical findings with one exception. Status epilepticus was not encountered and only one patient had more seizures (4.0/mo) during the lithium carbonate treatment period than during the baseline period (1.8/mo). References 1. Garrod AB: Gout and Rheumatic Gout . London, Walton & Maberly, 1859. 2. Cade JFJ: Lithium salts in the treatment of psychotic excitement . Med J Aust 36:349-352, 1949. 3. Schou M, et al: The treatment of manic psychosis by the administration of lithium salts . J Neurol Neurosurg Psychiatry 17:250-260, 1954.Crossref 4. Maggs R: Treatment of manic illness with lithium carbonate . Br J Psychiatry 109:56-65, 1963.Crossref 5. Schou M, Amdisen A, Trap-Jensen J: Lithium poisoning . Am J Psychiatry 125:520, 1968. 6. Wharton RN: Grand mal seizures with lithium treatment . Am J Psychiatry 126:1446, 1969. 7. Baldessarini R, Stephens J: Lithium carbonate for affective disorders . Arch Gen Psychiatry 22:72, 1970.Crossref 8. Demers R, Lukesh R, Prichard J: Convulsion during lithium therapy . Lancet 2:315-316, 1970. 9. Mayfield D, Brown RG: The clinical laboratory and electroencephalographic effects of lithium . J Psychiatr Res 4:207-219, 1966.Crossref 10. Johnson G, et al: The effects of lithium on electroencephalogram, behavior and serum electrolytes . J Nerv Mental Dis 151:273-289, 1970.Crossref 11. James JF, Reilly E: The electroencephalographic recording of short- and long-term lithium effect . Southern Med J 64:1322-1327, 1971.Crossref 12. Johnson G: Lithium and the EEG: An analysis of behavioral, biochemical and electrographic changes . Electroenceph Clin Neurophysiol 27:656-657, 1969. 13. Garthside IB, Lippold OCJ, Meldrum BS: The evoked cortical somatosensory response in normal men and its modification by oral lithium carbonate . Electroenceph Clin Neurophysiol 20:382-390, 1966.Crossref 14. Glaser GH: Sodium and seizures . Epilepsia 5:97-111, 1964.Crossref 15. Coirault R, Jeanneton C: Epilepsie et metabolisme Cellulaire . Paris, Maloine, 1959. 16. Giacobini E: The effect of lithium on the nerve cell . Acta Psychiatr (Scand) [ (Suppl) ] 207:85-91, 1969.Crossref 17. Hodgkin AL, Katz B: The effect of sodium ions on the electrical activity of the giant axon of the squid . J Physiol 108:37-77, 1949. 18. Radomski JL, et al: The toxic effects, excretion and distribution of lithium chloride . J Pharmacol Exp Ther 100:429-436, 1950.
Archives of General Psychiatry – American Medical Association
Published: May 1, 1973