Systematic review, 2019
Do lithium and valproate levels change during the menstrual cycle?
In women with bipolar disorder, lithium levels decreased during the luteal phase (before the period) despite stable doses, linked to worsening mood symptoms. In healthy women, lithium levels were not affected by the menstrual cycle.
What they did
Systematic review of 5 studies examining whether blood levels of lithium and valproate change during different menstrual cycle phases. Most studies included women with bipolar disorder or epilepsy.
What they found
In women with bipolar disorder, lithium levels showed a significant decrease during the luteal phase despite stable oral doses, linked to cyclic worsening of mood symptoms before the period. In healthy women, lithium levels were not influenced by menstrual cycle phases or oral contraceptive use. Valproate levels in epileptic women showed a small, nonsignificant decline during the mid-luteal phase.
What it means for you
If you take lithium for bipolar disorder, your blood levels may drop before your period, potentially worsening mood symptoms. Talk to your doctor about dose adjustments during your cycle. This finding comes from a small number of studies.
5
studies reviewed
4
studies assessing lithium levels
1
study assessing valproate levels
About the study
- Original title
- Lithium and valproate serum level fluctuations within the menstrual cycle: a systematic review
- Authors
- Carmassi C, Del Grande C, Masci I et al.
- Journal
- International clinical psychopharmacology
- Year
- 2019
- Study design
- Systematic review
- What was tested
- Monitoring of lithium and valproate levels during menstrual cycle
- Open access
- Yes
- Read the paper
- doi.org/10.1097/yic.0000000000000253
Topics
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