Am J Psychiatry 1990; 147:615-620
Copyright © 1990 by American Psychiatric Association
Addition of lithium carbonate to carbamazepine: hematological and thyroid effects
KG Kramlinger and RM Post
Biological Psychiatry Branch, NIMH, Bethesda, MD 20892.
In view of the increasing use of lithium-carbamazepine combination therapy
for refractory psychiatric disorders, the authors assessed the clinical
laboratory effects of adding lithium to carbamazepine in 23 patients with
affective disorders. Lithium produced a robust reversal of
carbamazepine-induced leukopenia, increasing WBCs, predominantly
neutrophils, to levels significantly above placebo baseline values. The
combination produced additive antithyroidal effects, resulting in greater
decreases in T4 and free T4 than with carbamazepine alone; the addition of
lithium was associated with the emergence of a modestly higher TSH level.
The authors discuss clinical and theoretical implications of these
findings.
