Lithium Monitoring by Reverse Iontophoresis in Vivo.pdfVIP

Clinical Chemistry 50:11 2091–2100 (2004) Drug Monitoring and Toxicology Lithium Monitoring by Reverse Iontophoresis in Vivo Benoıˆt Leboulanger,1,3 Jean-Michel Aubry,2 Guido Bondolfi,2 Richard H. Guy,1,3 and M. Begon˜ a Delgado-Charro1,3* Background: We investigated reverse transdermal ion- Conclusions: Reverse iontophoresis appears to offer a tophoresis as an alternative, noninvasive method for novel and accurate method for lithium monitoring. lithium monitoring in vivo. The objectives of such an © 2004 American Association for Clinical Chemistry approach would be to facilitate compliance with treat- ment and to improve the quality of life for bipolar Fifty years after the first report of its antimanic effects (1), patients. lithium remains a first-choice mood stabilizer for prevent- Methods: We studied 23 bipolar or schizo-affective ing relapses in bipolar disorders (1–3). It is also the only patients. Over a 2-h period, we extracted lithium and mood stabilizer for which a preventive effect on suicidal other cations across intact skin by application of an risk has been clearly shown (3, 4). Regular lithium mon- electric current (0.8 mA) and quantified the concentra- itoring is essential to ensure efficacy and to prevent tions by ion chromatography. A blood sample provided adverse effects (5). Although steady-state plasma concen- comparative reference values for the drug a