Bipolar Disorder/lithium related

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Expert: - 3/12/2004


Question
Doctor:  My mother takes 750mg of lithium daily and her family doctor placed her on an ace inhibitor for hypertension, she then started having frequent diarrhea and had a lithium level taken and it was up enough to concern her psychiatrist, she is 64 now and i was wandering if it is a general practice with lithium to avoid ace inhibitors totally or can they be used it the lithium is adjusted?  Thanks for your input.


Answer
ACE inhibitors are known the increase lithium levels by over 30%.  In many individuals this is enough to cause side-effects such as diarrhea.  When someone on lithium is given an ACE inhibitor, the dose of lithium should be reduced by 1/3 to 1/2 and then adjusted on the basis of lithium blood tests.

Best regards . . .

Ivan
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Bipolar Disorder

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Ivan Goldberg, M.D.

Expertise

I am a psychiatrist/psychopharmacologist with many years of expereince in treating individuals with depressions, manic-depression (Bipolar Disorder), other mood disorders,. I am especially interested in the psychopharmacologic treatment of individuals with so called "treatment-resistant" syndromes.

Experience

I have been on the staff of the National Institute of Mental Health, Columbia's College of Physicians and Surgeons, and the Columbia-Presbyterian Medical Center. I am currently in full-time private practice in New York City.

A.B. Johns Hopkins University
M.D. N.Y.U. College of Medicine

I am the creator of Depression Central:http://www.psycom.net/depression.central.html

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