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March 1984

Aspirin Increases Serum Lithium Ion Levels-Reply

Author Affiliations

Dr Margarete Fischer-Bosch-Institut für Klinische Pharmakologie Auerbachstrasse 112 7000 Stuttgart 50, West Germany

Arch Gen Psychiatry. 1984;41(3):311. doi:10.1001/archpsyc.1984.01790140101016

In Reply.—  The most obvious difference between the preliminary data presented by Bendz and Feinberg on one subject and our study is that we monitored sodium intake by administering a diet and sodium excretion by measuring daily 24-hour urinary sodium excretion throughout the study.None of our volunteers showed an increase in plasma levels of lithium ions or a decrease in lithium ion clearance during aspirin administration. We have, furthermore, recently studied the acute effect of intravenous aspirin (2 g within three hours) in six healthy volunteers in lithium ion (0.6 to 0.8 mEq/L) and sodium (150 mEq/L) steady-state balance. During the relatively short period of aspirin infusion, we neither observed nor expected an increase in plasma lithium ion clearance,1 confirming our previous observation.The rate of renal elimination of lithium ions depends critically on sodium balance.2 Because the rate of renal elimination of lithium ions is the most

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