The unfortunate experience with lithium chloride as a salt substitute in
the 1940s still directs the clinical usuage of lithium carbonate to a
certain extent. We are still warned that lithium salts should never be used
in low-sodium situations (e.g., with thiazide diuretics or salt- restricted
diets); however, it has recently been shown that thiazide diuretics may be
safely used in the treatment of lithium-induced nephrogenic diabetes
insipidus (NDI). The authors recapitulate the dangers inherent in the use
of this drug combination and present detailed clinical-pharmacologic data
on 13 patients which suggest that thiazides are useful in the treatment of
lithium-induced NDI and may actually synergize with lithium to produce
improved mood control in some lithium-refractory manic-depressive
patients.Abstract Teaser