Abstract
Lithium carbonate was administered to 18 patients with recurrent affective or schizoaffective disorders and a number of parameters of water and electrolyte metabolism and related adrenal cortical functions were studied longitudinally. Serum K + and Mg ++ levels increased significantly while patients were on lithium but serum Na + and Ca ++ levels did not change. There were transient increases in urinary volume and 24-hr Na + and aldosterone output, but no change in urinary 17-hydroxycorticosteroids. There were also sustained increases in urinary volume and urinary aldosterone output. Eleven of the patients had repeated measurements of 24-hr exchangeable sodium as well as several measurements of extracellular space. There was a significant increase in 24-hr exchangeable sodium mass and space during lithium administration. These changes were much larger in patients whose affective disorders improved while on lithium, whether they were manic or depressed when treatment began. The interrelationship between some of these changes is analyzed and discussed in detail.
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