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Some Practical Aspects of Lithium Treatment:  Blood Levels, Dosage Prediction, and Slow-Release Preparations

Paul Grof, MD
Arch Gen Psychiatry. 1979;36(8):891-893. doi:10.1001/archpsyc.1979.01780080065015.
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The purpose of this report is to discuss practical issues in lithium management, focusing on (a) the reasons for standardizing procedures for drawing blood for the determination of serum lithium levels, (b) a discussion of the findings to date concerning slow-release lithium preparations, and (c) single dosage prediction of serum lithium levels, a technique particularly valuable in clinical situations that require patients to reach promptly a desired serum lithium concentration.

SERUM LITHIUM LEVELS  Historically, the appreciation of the clinical value of serum lithium levels has developed slowly, from monitoring safety through monitoring adequacy of lithium treatment to the management of lithium intoxication. After initial disappointments, it gradually became clear that serum lithium levels can be of substantial use only if the blood samples are drawn in a standardized way. Defining the best conditions for the standardization of serum lithium levels had to take into account the pharmacokinetics of lithium as

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