RBC‐choline: changes by lithium and relation to prophylactic response

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Abstract
ABSTRACT–Red blod cell (RBC)‐ and plasma‐choline levels were measured in patients on lithium (n= 96), antidepressants (n‐ 32) and nenroleptics (n= 51), and in 25 healthy drug‐free controls. Lithium patients exhibited highly increased RBC‐ and slightly increased plasma‐choline levels compared with controls (P < 0.001 and P < 0.05, respectively); the choline ratio (RBC‐/plasma‐choline) was elevated almost to the same extent as RBC‐choline (P < 0.001). With antidepressants RBC‐choline and choline ratios were slightly reduced (P < 0.05), whereas neuroleptics showed no effect on choline levels. 79 % of lithium patients were responders (reduction in hospitalizations with lithium), 21 % were non‐responders (no reduction or increase in hospitalizations]. Choline ratio exhibited a significant relation to prophylactic lithium response, but lithium ratio did not. The percentage of nori‐responders was significantly higher in patients with a choline ratio exceeding 100 than in patients with a choline ratio below this cut‐off (P < 0.01). Thus, the increase of RBC‐choline and choline ratios appears to be an effect specific for lithium and might be related to the outcome of lithium prophylaxis.