Effects of Lithium Treatment on Granulocytes and Granulocyte Colony-Stimulating Factor in Patients with Bipolar Affective Disorder

EFFECTS OF LITHIUM TREATMENT ON GRANULOCYTES AND GRANULOCYTE COLONY-STIMULATING FACTOR IN PATIENTS WITH BIPOLAR AFFECTIVE DISORDER Objective: Although there are conflicting results, lithium carbonate has been demonstrated to induce the production of haematopoietic cells, particularly white blood cell series. In this study, we examined the effects of lithium on white blood cells in association with granulocyte colony-stimulating factor (G-CSF), which is a polypeptide growth factor that regulates the production of neutrophilic granulocytes. Methods: Eighteen lithiumnaive (8 females, 10 males; mean±SD age: 36±7.9 years) and 20 long-term lithium treated (9 females, 11 males; mean±SD age: 37.4±9.5 years) bipolar patients were included in the study. In the lithium-naive patients, lithium treatment was started to provide prophylactic serum lithium concentrations after blood samples were taken to determine the baseline haematological values (white blood cell, granulocyte and lymphocyte counts, haematocrit and G-CSF concentration). Blood samples were reobtained in the first and fourth weeks in this group. The same measurements were fulfilled once in the patients on the longterm lithium treatment. Results: The values of granulocyte count were significantly increased in the fourth week of lithium administration compared to the baseline values in the patients who were in the short-term lithium treatment, and this increase was associated with some elevation of G-CSF values that did not reach significance. The values of granulocyte count in the longterm lithium group were not significantly different from those of the baseline values of lithium-naive patients. Conclusion: Granulocytosis induced by lithium treatment in bipolar patients cannot be explained solely by the stimulation of G-CSF activity. Increased granulocyte count seems to approach the baseline values during the long-term lithium treatment.