Lithium is a drug commonly prescribed for patients with psychiatric disorders, namely bipolar disorder, schizophrenia, and depression. It is used as a mood stabilizer and decreases the intensity of manic episodes, with particular benefit in reducing suicidal tendencies. Although very effective, the drug requires routine blood monitoring, which can be uncomfortable, expensive, and inconvenient for patients who have to travel to clinical laboratories for frequent blood tests.
Research from the University of California, Irvine Institute for Interdisciplinary Saliva Bioscience (IISBR) indicates that saliva testing is a potential alternative to blood sampling. Compared to blood, saliva collection is easier, non-invasive, requires less processing, and can be done in any environment.
A recent study published in the international journal Bipolar disorders showed a strong correlation between saliva and serum lithium levels and that the saliva-to-serum ratio in an individual could robustly predict a patient’s serum lithium level. These results suggest that saliva could in fact be used for lithium monitoring in patients with mood troubles.
Over the course of 18 months, researchers collected 171 saliva samples from 75 diagnosed patients bipolar disorder, schizophrenia, schizoaffective disorder, major depressive disorder or generalized anxiety disorder.
The results of the study will fill critical gaps in the literature on the effectiveness of saliva for drug monitoring. Although there is a large body of work dating back 30 years, the samples were small, the techniques were varied, and older methods were used. The study, along with the ongoing work at IISBR, will open the door to the development and implementation of new saliva analysis methods, which will undoubtedly improve treatment options for patients taking lithium drugs, as well as the overall experience of psychiatric patients.
Co-investigators on the study include UCI Public Health Epidemiology PhD student and corresponding author Georgia Parkin; Elizabeth A. Thomas, epidemiology researcher at UCI in public health and at IISBR, Ph.D.; Hillary Piccerillo, head of the IISBR laboratory; and Professor Emeritus and Former Director of IISBR Douglas A. Granger, Ph.D.
Georgia M. Parkin et al, Saliva testing as a means of monitoring therapeutic lithium levels in patients with psychiatric disorders: identification of clinical and environmental covariates, and their incorporation into a predictive model, Bipolar disorders (2021). DOI: 10.1111 / bdi.13128
University of California, Irvine
Study examines saliva tests for medication monitoring in patients with psychiatric disorders (2021, October 4)
retrieved on October 5, 2021
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