the effect of concurrent administration of typical or atypical antipsychotic drugs and lithium on lithium ratio in acute manic patients

objective: the lithium concentration in the plasma is assumed to give someindication as to the concentration of this ion in different organ cells especially incentral nervous system. while the practical value of intracellular lithium measurement is controversial however, erythrocytes have proved to be useful for studying lithium concentration and its transport across the membrane. there are some reports suggesting that neuroleptic drugs are able to affect the erythrocyte lithium concentration (elcs), although these studies have yielded inconsistent results. method: in the present study the effect of risperidone and olanzapine as atypical antipsychotic and haloperidol as standard typical antipsychotic on lithium ratio in 46 acute manic patients was studied. elcs were measured using atomic absorption spectrophotometer. clinical response was evaluated by using young mania rating scale (ymrs). results: no significant difference was found between lrs and dose or type of antipsychotics. also there were no significant differences between lrs and clinical response or remission. conclusion: the concurrent use of an atypical antipsychotics and lithium may not significantly alter the lithium transport in the erythrocyte and presumably in the nerve cells. a more comprehensive study is warranted to confirm the results of this study.