{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T02:38:44Z","timestamp":1790995124864,"version":"4.1.0"},"reference-count":19,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2022,7,13]],"date-time":"2022-07-13T00:00:00Z","timestamp":1657670400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["accp1.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Clinical Pharma"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The pharmacokinetics of lithium, the gold standard for the treatment of bipolar disorder, are well described in nonpregnant patients. Because lithium is commonly prescribed to women of childbearing age, more data are essential to characterize lithium pharmacokinetics during the perinatal period. Lithium is primarily eliminated by the kidney. As a result, shifts in lithium elimination clearance parallel pregnancy\u2010related changes in glomerular filtration rate. Lithium's narrow therapeutic window increases the risk for therapeutic failure and toxicity when lithium elimination clearance is altered. To characterize the pharmacokinetics of lithium in pregnancy and postpartum, 3 women treated with lithium for bipolar disorder completed serial blood sampling protocols during each trimester of pregnancy and at least once postpartum. The trajectory of lithium elimination clearance, creatinine clearance, and serum lithium concentrations were determined. Manic, depressive, and anxiety symptoms were also assessed at each study visit. Compared to the nonpregnant state, lithium elimination clearance increased an average of 63.5% by the third trimester. Lithium elimination clearance was inversely related to changes in serum lithium concentration. Mood symptoms worsened with declines in serum lithium concentration. Lithium elimination clearance returned to baseline at 4 to 9 weeks postpartum. To maintain lithium effectiveness during pregnancy and prevent toxicity postpartum, lithium therapeutic drug monitoring and dose adjustments are warranted.<\/jats:p>","DOI":"10.1002\/jcph.2089","type":"journal-article","created":{"date-parts":[[2022,5,27]],"date-time":"2022-05-27T07:18:23Z","timestamp":1653635903000},"page":"1385-1392","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Lithium Pharmacokinetics in the Perinatal Patient With Bipolar Disorder"],"prefix":"10.1002","volume":"62","author":[{"given":"Crystal T.","family":"Clark","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Asher Center for the Study and Treatment of Depressive Disorders Northwestern University Feinberg School of Medicine  Chicago Illinois USA"},{"name":"Department of Obstetrics and Gynecology Northwestern University Feinberg of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6162-5619","authenticated-orcid":false,"given":"Rebecca L.","family":"Newmark","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Asher Center for the Study and Treatment of Depressive Disorders Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine L.","family":"Wisner","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Asher Center for the Study and Treatment of Depressive Disorders Northwestern University Feinberg School of Medicine  Chicago Illinois USA"},{"name":"Department of Obstetrics and Gynecology Northwestern University Feinberg of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Stika","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Northwestern University Feinberg of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Avram","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,7,13]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-5618.2007.00475.x"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.12805"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.158.6.906"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0165-0327(94)00091-M"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40345-019-0151-2"},{"key":"e_1_2_8_7_1","first-page":"1116","volume-title":"Textbook of Medical Physiology","author":"Guyton AC","year":"2006"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ackd.2013.01.012"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.5859.137"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.116.192799"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-015738"},{"issue":"20","key":"e_1_2_8_12_1","first-page":"22","article-title":"The Mini\u2010International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM\u2010IV and ICD\u201010","volume":"59","author":"Sheehan DV","year":"1998","journal-title":"J Clin Psychiatry"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291700035558"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.166.10.1092"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.133.5.429"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0026-0495(98)90064-6"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.1994.47"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2007.06101639"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.4103\/0253-7176.135399"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-197702020-00001"}],"container-title":["The Journal of Clinical Pharmacology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcph.2089","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jcph.2089","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/accp1.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcph.2089","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T00:34:46Z","timestamp":1692664486000},"score":1,"resource":{"primary":{"URL":"https:\/\/accp1.onlinelibrary.wiley.com\/doi\/10.1002\/jcph.2089"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,13]]},"references-count":19,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2022,11]]}},"alternative-id":["10.1002\/jcph.2089"],"URL":"https:\/\/doi.org\/10.1002\/jcph.2089","archive":["Portico"],"relation":{},"ISSN":["0091-2700","1552-4604"],"issn-type":[{"value":"0091-2700","type":"print"},{"value":"1552-4604","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,13]]},"assertion":[{"value":"2022-02-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-05-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-07-13","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}