Observational studyBMJ open2017
Changes in drug disposition of lithium during pregnancy: a retrospective observational study of patient data from two routine therapeutic drug monitoring services in Norway.
Observational study in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- Canadian Network for Mood and Anxiety Treatments 2024 Clinical Practice Guideline for the Management of Perinatal Mood, Anxiety, and Related Disorders: Guide de pratique 2024 du Canadian Network for Mood and Anxiety Treatments pour le traitement des troubles de l'humeur, des troubles anxieux et des troubles connexes périnatals.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2025Guideline
- Clinical Lactation Studies of Lithium: A Systematic Review.Frontiers in pharmacology · 2019Pooled it
- Management of Lithium in Pregnancy and Lactation: An Individualized Approach.Current psychiatry reports · 2026Review
- Obstetric Outcomes in Women on Lithium: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2024Review
- Advances in Psychotropic Treatment for Pregnant Women: Efficacy, Adverse Outcomes, and Therapeutic Monitoring.Journal of clinical medicine · 2024Review
- Depression Treatment in Pregnancy: Is It Safe, or Is It Not?International journal of environmental research and public health · 2024Review
- [Psychopharmacotherapy during pregnancy and breastfeeding-Part I: focus on pregnancy : Support options by using therapeutic drug monitoring].Der Nervenarzt · 2023Review
- Current Status of Therapeutic Drug Monitoring in Mental Health Treatment: A Review.Pharmaceutics · 2022Review
- Lithium Pharmacokinetics in the Perinatal Patient With Bipolar Disorder.Journal of clinical pharmacology · 2022Article
- Metformin serum concentrations during pregnancy and post partum - A clinical study in patients with polycystic ovary syndrome.Basic & clinical pharmacology & toxicology · 2022Article
- Management of lithium dosing around delivery: An observational study.Bipolar disorders · 2021Observational
- Case Report: Clinical and Pharmacokinetic Profile of Lithium Monotherapy in Exclusive Breastfeeding. A Follow-Up Case Series.Frontiers in pharmacology · 2021Article
- Neonatal Feeding Trajectories in Mothers With Bipolar Disorder Taking Lithium: Pharmacokinetic Data.Frontiers in pharmacology · 2021Article
- Lithium Treatment Over the Lifespan in Bipolar Disorders.Frontiers in psychiatry · 2020Review
- Lithium Use and Non-use for Pregnant and Postpartum Women with Bipolar Disorder.Current psychiatry reports · 2019Review
- Lithium during pregnancy and after delivery: a review.International journal of bipolar disorders · 2018Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesPregnancy may cause changes in drug disposition, dose requirements and clinical response. For lithium, changes in disposition during pregnancy have so far been explored in a single-dose study on 4 participants only. The aim of this study was to determine the effect of pregnancy on serum levels of lithium in a larger patient material in a naturalistic setting.
designA retrospective observational study of patient data from 2 routine therapeutic drug monitoring services in Norway, linked to the Medical Birth Registry of Norway.
settingNorway, October 1999 to December 2011. MEASUREMENTS: Dose-adjusted drug concentrations of lithium during pregnancy were compared with the women's own baseline (non-pregnant) values, using a linear mixed model.
resultsOverall, coupling 196 726 serum concentration measurements from 54 393 women to the national birth registry identified 25 serum lithium concentration analyses obtained from a total of 14 pregnancies in 13 women, and 63 baseline analyses from the same women. Dose-adjusted serum concentrations in the third trimester were significantly lower than baseline (-34%; CI -44% to -23%, p<0.001).
conclusionsPregnancy causes a clinically relevant decline in maternal lithium serum concentrations. In order to maintain stable lithium concentrations during the third trimester of pregnancy, doses generally need to be increased by 50%. Individual variability in decline implies that lithium levels should be even more closely monitored throughout pregnancy and in the puerperium than in non-pregnant women to ensure adequate dosing.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.