Journal of the American Academy of Child Psychiatry
Volume 25, Issue 6 , Pages 852-853, November 1986

Recurrent Premenstrual Decline in Serum Lithium Concentration: Clinical Correlates and Treatment Implications

  • CYNTHIA D. CONRAD, M.D., PH.D.

      Affiliations

    • Corresponding Author InformationReprints may be requested from: Cynthia D. Conrad, M.D., Ph.D., The Institute of Living, 400 Washington St., Hartford, CT 06106
  • ,
  • JEAN A. HAMILTON, M.D.

From The Institute of Living, Hartford, Conn. (Dr. Conrad), and the Institute for Research on Women's Health, Washington, D. C. (Dr. Hamilton)

Received 15 July 1985; accepted 18 September 1985.

A 16-year-old female adolescent who met DSM-III criteria for bipolar disorder, mixed with psychotic features, showed a clinical response to lithium carbonate, but experienced repeated deterioration in function whenever she entered the premenstrual phase of her menstrual cycle. This exacerbation in her affective psychosis coincided with a progressive fall in serum lithium concentration despite a constant oral regimen with which the patient was compliant. If the oral dose was prophylactically increased during the patient's luteal phase in order to compensate for the anticipated decline in serum concentration, and if the concentration could thereby be maintained at or above 1.1 mEq/L, then the premenstrual deterioration could be prevented.

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PII: S0002-7138(09)60206-5

doi:10.1016/S0002-7138(09)60206-5

Journal of the American Academy of Child Psychiatry
Volume 25, Issue 6 , Pages 852-853, November 1986