Skip to main content
Log in

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

  • Original Investigations
  • Published:
Psychopharmacology Aims and scope Submit manuscript

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Akaike N (1981) Sodium pump in skeletal muscle: Central nervous system-induced suppression by alpha-adrenoceptors. Science 213:1252–1254

    Google Scholar 

  • Betts R, Paschalis C, Jarrat J, Jenner FA (1978) Nerve refractory period in patients treated with rubidium and lithium. J Neurol Neurosurg Psychiat 41:791–793

    Google Scholar 

  • Bond PA, Dimitrakoudi M, Howlett DR, Jenner FA (1975) Urinary excretion of the sulphate and glucuronide of 3-methoxy-4-hydroxyphenylethyleneglycol in a manic-depressive patient. Psychological Medicine 5:279–285

    Google Scholar 

  • Boulenger JP, Boutillier H, Dachary JM, Goujet MA, Lôo H, Raynaud G, Scharbach H, Vadrot M (1977) Point actuel sur le rubidium. L'Encéphale 3:333–356

    Google Scholar 

  • Brading AF, Jones AW (1969) Distribution and kinetics of Coedta, in smooth muscle, and its use as an extracellular marker. J Physiol 200:387–401

    Google Scholar 

  • Brunswick DJ, Frazer A, Mendels J, Ramsey TA (1978) Red blood cell Li+ to plasma Li+ ratios. Neuropsychobiology 4:121–127

    Google Scholar 

  • Burkinshaw L (1978) Sex-dependent calibration factor of a whole-body radiation counter. Int J Appl Radiat Isot 29:387–390

    Google Scholar 

  • Cade JFJ (1962) The relation between recovery and plasma potassium levels in manic states. Med J Aust 23:911–913

    Google Scholar 

  • Carroll BJ, Sharp PT (1971) Rubidium and lithium: opposite effects on amine-mediated excitement. Science 172:1355–1357

    Google Scholar 

  • Choi SJ, Taylor MA, Abrams R (1977) Depression, ECT, and erythrocyte adenosinetriphosphatase activity. Biol Psychiat 12:75–81

    Google Scholar 

  • Dawes C (1969) The effects of flow rate and duration of stimulation on the concentration of protein and the main electrolytes in human parotid saliva. Arch Oral Biol 14:277–294

    Google Scholar 

  • Dickerson JWT, Widdowson EM (1960) Chemical changes in skeletal muscle during development. Biochem J 74:247–257

    Google Scholar 

  • Ettigi PG, Brown GM (1979) Psychoendocrine correlates in affective disorder. In: Müller EE, Agnoli A (eds) Neuroendocrine correlates in neurology and psychiatry. Elsevier/North Holland, Amsterdam, pp 225–238

    Google Scholar 

  • Frazer A, Fitzgerald RG, Mendels J (1972a) Erythrocyte cation concentrations and changes in dietary electrolyte intake. Experientia 28:1302–1303

    Google Scholar 

  • Frazer A, Secunda SK, Mendels J (1972b) A method for the determination of sodium, potassium, magnesium and lithium concentrations in erythrocytes. Clin Chim Acta 36:499–509

    Google Scholar 

  • Funder J, Wieth JO (1966) Chloride and hydrogen ion distribution between human red cells and plasma. Acta Physiol Scand 68:234–245

    Google Scholar 

  • Georgotas A, Dunner DL, Meltzer HL, Solomon M, Fieve RR, Gershon S (1980) The importance of dietary control in metabolic studies of manic-depressive patients. Biol Psychiat 15:157–163

    Google Scholar 

  • Glendening BL, Schrenk WG, Parrish DB (1956) Effects of rubidium in purified diets fed rats. J Nutrit 60:563–579

    Google Scholar 

  • Gosling R, Kerry RJ, Owen G (1972) Creatine phosphokinase activity during lithium treatment. Brit Med J 3:327–329

    Google Scholar 

  • Gwirtsman HE, Meltzer HL, Dunner DL, Fieve RR, Pierson RN (1980) Rubidium replacement of total body potassium in humans. Horm Metab Res 12:175

    Google Scholar 

  • Hesketh JE, Loudon JB, Reading HW, Glen AIM (1978) The effect of lithium treatment on erythrocyte membrane ATPase activities and erythrocyte ion content. Brit J Clin Pharmacol 5:323–329

    Google Scholar 

  • Hesketh JE, Reading HW (1978) Variation in adenosine triphosphatase activities in serial preparations of human erythrocyte membranes. Biochem Soc Trans 6:918–920

    Google Scholar 

  • Hilder JA, Ferguson MH (1955) The concentration of electrolytes in human saliva. Canad J Biochem Physiol 33:217–225

    Google Scholar 

  • Hill SE, Jenner FA, Lee CR, Paschalis C, Pollitt RJ, Sampson GA (1979) Urinary dicarboxylic acids in patients receiving lithium or rubidium salts. Psychopharmacology 65:85–87

    Google Scholar 

  • Hokin-Neaverson M, Spiegel DA, Lewis WC (1975) Deficiency of erythrocyte sodium pump activity in bipolar manic-depressive psychosis. Life Sci 15:1739–1748

    Google Scholar 

  • Hullin RP (1975) The effects of lithium on electrolyte balance and body fluids. In: Johnson FM (ed) Lithium research and therapy. Academic, London New York San Francisco, pp 359–379

    Google Scholar 

  • Jenner FA, Gjessing LR, Cox JR, Davies-Jones A, Hullin RP, Hanna SM (1967) A manic depressive psychotic with a persistent forty-eight hour cycle. Brit J Psychiat 113:895–910

    Google Scholar 

  • Kilpatrick R, Renschler GE, Munro DS, Wilson GM (1956) A comparison of the distribution of 42K and 86Rb in rabbit and man. J Physiol 133:194–201

    Google Scholar 

  • Lambie AT, Relman AS, Schwartz WB, Roy AM (1959) Electrolyte and acid-base balance during acute loading with rubidium chloride. J Clin Invest 38:1538–1543

    Google Scholar 

  • Lashley KS (1916) The human salivary reflex and its use in psychology. Psychol Rev 23:446–464

    Google Scholar 

  • Lee CR, Paschalis C (1978) Lithium metabolism as a guide to the selection of patients for lithium therapy. In: Johnson FM, Johnson S (eds) Lithium in medical practice. MTP, Lancaster, pp 365–379

    Google Scholar 

  • Lim M, Linton RAF, Wolff CB, Band DM (1981) Propranolol, exercise, and arterial plasma potassium. The Lancet 2:591

    Google Scholar 

  • Martin K (1978) Irreversible effects of lithium administration on transport processes in erythrocytes and platelets. In: Johnson FM, Johnson F (eds) Lithium in medical practice. MTP, Lancaster pp 167–171

    Google Scholar 

  • Meltzer HY (1973) Skeletal muscle abnormalities in patients with affective disorders. J Psychiat Res 10:43–57

    Google Scholar 

  • Meltzer HL, Fieve RR (1975) Rubidium in psychiatry and medicine; an overview. In: Current developments in psychopharmacology, vol 1. Spectrum, New York, pp 205–242

    Google Scholar 

  • Meltzer HL, Kassir S, Dunner DL, Fieve RR (1977) Repression of a lithium pump as a consequence of lithium ingestion by manic-depressive subjects. Psychopharmacology 54:113–118

    Google Scholar 

  • Moon RB, Richards JH (1973) Determination of intracellular pH by 31P magnetic resonance. J Biol Chem 248:7276–7278

    Google Scholar 

  • Moore-Ede MC, Brennan MF, Ball MR (1975) Circadian variation of intercompartmental potassium fluxes in man. J Appl Physiol 38:163–170

    Google Scholar 

  • Moore-Ede MC, Meguid MM, Fitzpatrick GF, Boyden CM, Ball MR (1978) Circadian variation in response to potassium infusion. Clin Pharmacol Ther 23:218–227

    Google Scholar 

  • Naylor GJ, Reid AH, Dick DAT, Dick EG (1976) A biochemical study of short-cycle manic-depressive psychosis in mental defectives. Brit J Psychiat 128:169–180

    Google Scholar 

  • Ostrow DG (1979) Discussion of clinical papers on lithium transport in affective disorders. In: Ballus C, Gonzalez Monclus E (eds) Biological psychiatry today. Elsevier, Amsterdam, p 1159

    Google Scholar 

  • Paschalis C (1977) Psychochemedical studies with rubidium and lithium in affective disorders. PhD Thesis, University of Sheffield

  • Paschalis C, Jenner FA, Lee CR (1978) Effects of rubidium chloride on the course of manic-depressive illness. J R Soc Med 71:343–352

    Google Scholar 

  • Rahola T, Suomela M (1975) On biological half-life of potassium in man. Ann Clin Res 7:62–65

    Google Scholar 

  • Rapoport A, Evans BM, Wong H (1961) Observations on electrolytes in human saliva. Canad Med Assoc J 84:579–583

    Google Scholar 

  • Relman AS, Roy AM, Schwartz WB (1955) The acidifying effect of rubidium in normal and potassium deficient alkalotic rats. J Clin Invest 34:538–544

    Google Scholar 

  • Relman AS, Lambie AT, Burrows BA, Roy AM (1957) Cation accumulation by muscle tissue: the displacement of potassium and cesium in the living animal. J Clin Invest 36:1249–1256

    Google Scholar 

  • Reynolds EH (1976) Neurological aspects of potassium imbalance. In: Vinken PJ, Bruyn GW (eds) Metabolic and deficiency diseases of the nervous system (Handbook of clinical neurology, vol 28), part 2. North Holland, Amsterdam New York Oxford, pp 463–494

    Google Scholar 

  • Rhoads DB, Woo A, Epstein W (1977) Discrimination between Rb+ and K+ by escherichia coli. Biochim Biophys Acta 469:45–51

    Google Scholar 

  • Sachs JR, Welt LG (1967) The concentration dependence of active potassium transport in the human red blood cell. J Clin Invest 46:65–76

    Google Scholar 

  • Sanui H, Pace N (1968) Chemical and ionisation interferences in the atomic absorption spectrophotometric measurements of sodium, potassium, rubidium and cesium. Anal Biochem 25:330–346

    Google Scholar 

  • Shimi IAW, Higginson WCE (1958) Preparation of dihydrogen aquoethylenediaminetetraacetatocobalt (II) dihydrate. J Chem Soc 260

  • Silva P, Spokes K (1981) Sympathetic system in potassium homeostasis Am J Physiol 241 (Renal Fluid Physiol 10): F151-F155

    Google Scholar 

  • spirtes MA, Garey RE (1975) Serum erythrocyte and CNS levels in rhesus monkeys of orally and intravenously administered rubidium salts. Biol Psychiat 10:219–226

    Google Scholar 

  • Thaysen JH, Thorn NA, Schwartz IL (1954) Excretion of sodium, potassium, chloride and carbon dioxide in human parotid saliva. Am J Physiol 178:155–159

    Google Scholar 

  • Tosteson DC (1981) Cation countertransport and cotransport in human red-cells. Fed Proc 40:1429–1433

    Google Scholar 

  • Vadrot M, Scharback H, Raynaud G, Loo H, Dachary JM, Boutillier H, Boulenger JP (1979) Le cesium. L'Encephale 5:359–374

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Jenner, F.A., Lee, C.R., Paschalis, C. et al. Electrolyte metabolism in patients with periodic affective disorders during treatment with rubidium. Psychopharmacology 81, 301–309 (1983). https://doi.org/10.1007/BF00427567

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00427567

Key words

Navigation