Electrocardiographic Changes during Lithium Treatment

Electrocardiographic changes have been reported during therapy with psychotropic drugs—such as tricyclic anti-depressants (Schou 1963 ; Burrows et al., 1976 ; Reed and McKim 1978) and lithium (Tilkian et al., 1976a, 1976b; Wren and Dana 1976; Jefferson and Greist 1979). Lithium Carbonate affects ionic fluxes across cell membranes—-particularly those of sodium, potassium, calcium and magnesium (Carman et al., 1974; Durell, 1974) and thereby influences excitable tissues, like the nervous system and the heart. The changes induced in the heart are quite subtle and insidious and may be detected electrophysiologicaly without any manifest symptoms of cardiac involvement. The changes are often observed with serum lithium concentrations well within the therapeutic range and hence are to be sought for during routine maintenance therapy. The present paper describes the electrocardiographic changes noted in patients attending the Lithium clinic, Erskine hospital, Madurai during their regular follow-up. Observations from the Lithium clinic on the serum lithium—oral dose correlation, factors affecting therapeutic response and side effects of lithium therapy have been published elsewhere (Venkoba Rao and Hariharasubramanian, 1977, 1978).