The effects of lithium ions on the antidiuretic action of vasopressin in the rat.

1 The effect of intravenous infusion of lithium, 2.56 mumol/min on the antidiuretic responses to antidiuretic hormone (ADH), adenosine triphosphate (ATP), 3'-5' adenosine cylic monophosphate (cyclic AMP) and theophyline was studied in water-loaded, alcohol-anaesthetized rats. 2 Lithium reversibly inhibits the antidiuretic response to all concentrations of ADH, depressing the maximum response but not changing the amount required for half maximal response. 3 The rate of increase of serum lithium relates more clearly to the inhibitory effect than does the serum concentration. 4 Sodium concentrations in the renal papilla seem to fall when serum lithium levels are rising. 5 Lithium inhibits the antidiuretic response to ATP and cyclic AMP but does not inhibit the response to theophyline.

The effect of lithium and related metal ions on the urinary excretion of 2-oxoglutarate and citrate in the rat.

1 Administration of lithium ions to rats, either acutely by intraperitoneal injection or chronically in food, causes increased excretion of 2-oxoglutarate and citrate.2 Chronic administration in food of rubidium and caesium causes decreased excretion of 2-oxoglutarate and citrate.3 The effects described are not due to changes in urine volume, nor pH, nor are they simply related to the excretion of the injected ion.4 Acute administration of lithium caused an increased level of 2-oxoglutarate in kidney and reduced the ratio of glutamate to 2-oxoglutarate.5 Renal gluconeogenesis in slices was only slightly affected by either acute administration of lithium to the animals or by its presence in the incubation medium of renal slices.

Some aspects of the inhibition of the action of antidiuretic hormone by lithium ions in the rat kidney and bladder of the toad Bufo marinus.

1. The effect of intravenous infusions of various ions on the antidiuretic action of antidiuretic hormone has been studied in rats.2. Lithium (13 mmol/l.) reversibly inhibits the antidiuretic responses. Similar concentrations of potassium, rubidium, strontium, magnesium, choline and calcium do not. Lithium has a similar effect on the antidiuretic activity of oxytocin.3. The inhibition is not simply related to blood nor whole body lithium concentrations.4. Lithium (2 mmol/l.) in contact with the serosal surface also inhibits the transport of water facilitated by either 0.5 U/l. antidiuretic hormone or 1.1 mmol/l. cyclic adenosine monophosphate in the isolated toad bladder.5. Choline (2 mmol/l.) on the serosal surface also inhibits the transport of water facilitated by vasopressin in the toad bladder.

The distribution of lithium and its effects on the distribution and excretion of other ions in the rat.

1. In rats, lithium (ca 1 mEquiv/kg body weight) decreased brain sodium and magnesium, bone sodium and calcium and increased muscle calcium, plasma magnesium, urinary calcium and urine volume.2. Lithium was particularly concentrated in bone.

The effect of lithium salts on the urinary excretion of -oxoglutarate in man.

1. Lithium ions in therapeutic doses cause an increase in the renal excretion of alpha-oxoglutarate and glutaric acid.2. The excretion is probably due to reduced renal tubular reabsorption.3. Neither citrate, lactate nor pyruvate excretion rises.

Electrolyte metabolism in patients with periodic affective disorders during treatment with rubidium.

Five patients suffering from periodic affective disorders with short mood-cycles were treated with rubidium chloride, producing peak erythrocyte concentrations between 9 and 13 mmol/l. Loading with rubidium was associated with decreased total body potassium, but red-cell potassium was unchanged. Regular mood-cycling was disturbed, together with the associated body-weight changes. There was a slight extracellular "metabolic" acidosis. Electrolyte concentrations fluctuate abnormally in these patients, and two muscle biopsy specimens had very low potassium contents.

Urinary dicarboxylic acids in patients receiving lithium or rubidium salts.

Lithium salts administered in therapeutic doses to four subjects who were kept on controlled diets increased up to fivefold the urinary output of some dicarboxylic acids. Some of the acids affected are intermediates in the tricarboxylic acid cycle, others are chemically similar but not directly related in metabolic terms. This is probably a direct effect on renal transport. Rubidium salts increased urinary 2-oxoglutarate output and blood 2-oxoglutarate levels, probably by some action on intermediary metabolism.

Diminished hypercapnic drive in endogenous or severe depression.

Resting breathing rate, resting end-tidal PCO2 and ventilatory response to CO2 were studied in patients with primary depression. Patients tended to breathe faster and showed decreased PECO2 levels when compared with control subjects. Carbon dioxide response was determined using a modification of the rebreathing technique of Read. Endogenous depressives, unlike reactive depressives, tended to give low CO2 responses and low CO2 thresholds. Carbon dioxide responses of patients on admission correlated highly with severity of depression. The modification of the standard rebreathing technique, and the relationship between CO2 response and physical and psychological variables are discussed.

Effects of rubidium chloride on the course of manic-depressive illness.

Clinical studies of the effects of rubidium ions on the course of manic-depressive illness are reported. It seems that rubidium tends to increase the length of manic phases and possibly reduces the extremes of mood. Rubidium did not seem to produce any severe side effects in the dose administered, but it has a long biological half-life and caution is still required. Some details of the CSF, RBC, saliva and plasma and urine kinetics are also reported.

Users' satisfaction with mental health services.

The opinion and level of satisfaction of the users of three different mental health services are presented as a way of evaluating the outcome of institutional and community approaches to psychiatric services. The information was collected in the cities of Concepcion (Chile), Sheffield (England) and Trieste (Italy) interviewing a sample of the users of the psychiatric services using a questionnaire specifically designed to suit the study's aims. The patients in Sheffield tended to support an eventual move towards a more community based service while the relatives appeared more interested in a general improvement of the traditional institutional facilities. In Trieste, patients as well as relatives are fully supportive of the community based services and reasonably aware of the difficulties. They want to improve things in the community. Finally, Chilean users show a considerable adherence to the more traditional and institutionalised ways of offering services and the levels of satisfaction were very high considering the conditions in which the help was delivered.

Attitudes of professional mental health workers to psychiatry.

An attempt is presented to measure and compare attitudes to and ideas about psychiatry and mental health services in Concepcion, Sheffield and Trieste. These cities have in some respects comparable populations but very different mental health services. Questionnaires in English, Italian and Spanish were used to assess the views of professional workers in the field. The information collected showed that the Italian professionals had the highest level of satisfaction with their work, showed most tolerance of deviant behaviour in the community, the least acceptance of diminished responsibility in law and a non-traditional view of psychiatry. Clearly Chilean professionals held a very traditional view and medicalised approach to mental illness but an encouraging theoretical approval towards eventual changes in the services, along with the lowest level of satisfaction with their work. Professionals from Sheffield held an intermediate position coming closer to the theoretical view of the Chileans but nearer to the Italian praxis and therapeutic approach.

Mentally abnormal homicide--a review of a special hospital male population.

The clinical, criminological and demographic characteristics of a Special Hospital population of male patients convicted of homicide are described. The results confirm much previous work on mentally abnormal homicide. Typically the patients come from a disadvantaged social background with poor employment records, a prior history of aggressive behaviour and a diagnosis of schizophrenia. Victims were usually known to the patient and often came from within his circle of family and friends. Only 25% of the patients were receiving treatment at the time of the offence. These findings are discussed in the light of the current literature.