RBC‐choline: changes by lithium and relation to prophylactic response

Abstract

– Red blod cell (RBC)- and plasma-choline levels were measured in patients on lithium (n= 96), antidepressants (n - 32) and nenroleptics (n= 51), and in 25 healthy drug-free controls. Lithium patients exhibited highly increased RBC- and slightly increased plasma-choline levels compared with controls (P < 0.001 and P < 0.05, respectively); the choline ratio (RBC-/plasma-choline) was elevated almost to the same extent as RBC-choline (P < 0.001). With antidepressants RBC-choline and choline ratios were slightly reduced (P < 0.05), whereas neuroleptics showed no effect on choline levels. 79 % of lithium patients were responders (reduction in hospitalizations with lithium), 21 % were non-responders (no reduction or increase in hospitalizations]. Choline ratio exhibited a significant relation to prophylactic lithium response, but lithium ratio did not. The percentage of nori-responders was significantly higher in patients with a choline ratio exceeding 100 than in patients with a choline ratio below this cut-off (P < 0.01). Thus, the increase of RBC-choline and choline ratios appears to be an effect specific for lithium and might be related to the outcome of lithium prophylaxis.