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Plus ça change? Switching lithium preparations

Lookup NU author(s): Dr David Cousins, Professor Allan Young



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists. Aims and method A supply disruption alert in 2020, now rescinded, notified UK prescribers of the planned discontinuation of Priadel® (lithium carbonate) tablets. This service evaluation explored lithium dose and plasma levels before and after the switching of lithium brands, in order to determine the interchangeability of different brands of lithium from a pharmacokinetic perspective. Results Data on the treatment of 37 patients switched from Priadel® tablets were analysed. Switching to Camcolit® controlled-release tablets at the same dose did not result in meaningful differences in plasma lithium levels. Dose adjustment and known or suspected poor medication adherence were associated with greater variability in plasma lithium levels on switching brands. Clinical implications For comparable pre- and post-switch doses in adherent patients, the most common brands of lithium carbonate appear to produce similar plasma lithium levels. British National Formulary guidance relating to switching lithium brands may be unnecessarily complex.

Publication metadata

Author(s): Cousins DA, Barnes TRE, Young AH, Delgado O, Paton C

Publication type: Article

Publication status: Published

Journal: BJPsych Bulletin

Year: 2023

Volume: 47

Issue: 2

Pages: 71-76

Print publication date: 01/04/2023

Online publication date: 18/02/2022

Acceptance date: 18/11/2021

Date deposited: 06/04/2022

ISSN (print): 2056-4694

ISSN (electronic): 2056-4708

Publisher: Cambridge University Press


DOI: 10.1192/bjb.2021.126


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