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Effect of Lithium-Carbonate Therapy on Adrenocortical Activity

Edward J. Sachar, MD; Leon Hellman, MD; Jacob Kream, PhD; David K. Fukushima, PhD; Thomas F. Gallagher, PhD
Arch Gen Psychiatry. 1970;22(4):304-307. doi:10.1001/archpsyc.1970.01740280016004.
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LITHIUM salts are now an increasingly used therapy for manic-depressive illness. They have been shown to be strikingly effective in the treatment of manic attacks and in the prophylaxis of recurrent manic episodes. Lithium salts may also have some prophylactic effect in diminishing the frequency of recurrent depressions.1 Their mode of action remains obscure, however, although effects on several biological systems have been noted.2 Platman and Fieve3 recently reported a frequent and substantial increase in the 8 AM levels of plasma cortisol in association with lithium ion therapy.3 While the serum levels of lithium ion in these patients were not reported, they were all in the therapeutic range (above 0.6 mEq/ liter).

To study further the possibility of a significant effect of lithium ion on adrenocortical activity, a group of patients were studied before and during lithium-carbonate therapy, utilizing isotopic measures of corti


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