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Bioavailability of lithium preparations


Lithium is effective in the prophylaxis of affective disorders1 2 and is being increasingly used. Lithium has a narrow therapeutic ratio and the difference between toxic and ineffective plasma concentrations is small. To avoid the fluctuations in plasma level which occur with the conventional lithium carbonate tablets (Camcolit - Camden) two sustained-release preparations Priadel (Delandale) and Phasal (Pharmax) have been introduced. In vitro, both Phasal and Priadel are released much more slowly than Camcolit into simulated gastric and intestinal fluids.3 In order to determine the appropriate dosage schedules, the bioavailabilities of these preparations should be established and constant for all patients. Regular estimations of serum lithium concentration are essential; to ensure the best therapeutic effect the level should be between 0.8 and 1.4mmol/litre in samples taken 12 hours after the last dose of lithium.4

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