Adverse effects of withdrawal of chronic lithium therapy on liver - a histological study.

Effects of withdrawal of chronic lithium therapy have been investigated on liver. Lithium carbonate powder (34.2 mg/kg body weight) was administered daily by oral route in the form of capsule for four weeks to 15 adult male rabbits whereas a control group of 15 rabbits was given empty capsules and normal diet. Serum lithium levels were measured at the beginning of the experiment and thereafter checked weekly. After 4 weeks of consumption of drug, serum lithium levels increased significantly. The mean serum lithium levels gradually dropped after one week and significant fall was seen after 2 weeks of sudden withdrawal but it did not touch the baseline. After four weeks, 5 rabbits in each group were sacrificed and their livers were examined to see the effect of drug on them. Two other groups of 5 rabbits each were sacrificed one and two weeks after lithium withdrawal, respectively. Cholangitis (60%) and hepatitis (40%) were observed in both withdrawal groups. Cholangiocarcinoma (40%) was observed predominantly with chronic lithium therapy. This study highlighted the effect of chronic lithium therapy and its sudden withdrawal. It is suggested that once started, lithium therapy may be withdrawn gradually.