Is There a System for Lithium Monitoring?
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Q:  Is There a System for Lithium Monitoring?


Dear Doctor Phelps,

Maintaining balanced levels of Lithium seems to be an important  issue in the the avoidance of side effects. Though no substitute for lab testing and monitoring by a competent Psychiatrist, it would perhaps be useful if someone made a Lithium monitoring Gizmo, a bit like the diabetic folks have for checking their blood glucose levels. Are you aware of such a device? 

Thank you.
 

Hello Simon Ė
Fingerstick lithium level systems do exist. One was FDA approved several years ago, but Iíve not seen much evidence of it being distributed, or marketed.  It costs $400.  The target users are doctorsí offices,  not individuals. I just looked to see if the company is online, and surprisingly found very little.  The patent holder is Akers, the device is called InstaRead Lithium,  and the company marketing it is ReliaLab, Inc., of Basking Ridge, New Jersey. (Why are they not on the internet?)

As you point out, there is no substitute for laboratory testing.  When I get a lithium level, I also have the opportunity to check a routine test of kidney function, creatinine, which I track over time (because after years of lithium use, particularly at high serum levels, there is a tendency for kidney function to decrease, and this routine test can see that coming).

Likewise, checking thyroid function is also important when people are taking lithium.  Not every time, but often, I will check a thyroid status when checking lithium. since neither creatinine nor thyroid status can be tested using a finger stick method, Iíve not been strongly inclined to use this in-office lithium testing system.

Finally, lithium levels should generally be stable enough, and far enough away from any problem levels, that routine monitoring and home is not necessary.  Thatís quite different from measuring glucose for people with diabetes, where big fluctuations can occur spontaneously and need quick management.

So overall, Iím not too enthused about the finger stick method, as you can gather.  But this tool has only recently arrived.  I will keep an open mind to see how it might be useful.

Dr. Phelps

 
Published June, 2009

 

 

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