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Lithium (Lithobid): Mood Stabilizing Medications, Side Effects & Dosage

What is lithium, and how does it work (mechanism of action)?

Lithium is used for the treatment of manic/depressive (bipolar) and depressive disorders. Lithium is a positively charged element or particle that is similar to sodium and potassium. It interferes at several places inside cells and on the cell surface with other positively charged atoms such as sodium, potassium, calcium, and magnesium which are important in many cellular functions.

Lithium interferes with the production and uptake of chemical messengers by which nerves communicate with each other (neurotransmitters). Lithium also affects the concentrations of tryptophan and serotonin in the brain. In addition, lithium increases the production of white blood cells in the bone marrow. Lithium’s effects usually begin within 1 week of starting treatment, and the full effect is seen by 2 to 3 weeks.

Lithium has been used since the 1950’s. The FDA approved lithium carbonate, the most common lithium preparation in 1970.

What brand names are available for lithium?

Lithobid

Is lithium available as a generic drug?

Yes

Do I need a prescription for lithium?

Yes

What are the uses for lithium?

What are the side effects of lithium?

WARNING

Lithium toxicity is closely related to serum lithium concentrations, and can occur at doses close to therapeutic concentrations. Facilities for prompt and accurate serum lithium determinations should be available before initiating therapy

Common side effects

The most common side effects that can occur in persons taking lithium are:

Many of the gastrointestinal side effects (nausea, taste alterations, diarrhea) often disappear with continued therapy. Additionally, they may be less common if lithium is taken in divided doses with meals. If diarrhea or excessive urination lead to dehydration, lithium toxicity is possible. Lithium also can cause changes in the electrocardiogram (EKG, ECG), low blood pressure, and decreased heart rate.

What is the dosage for lithium?

  • Doses vary widely and are adjusted based on measurements of the levels of lithium in the blood. Recommended blood levels are 0.6-1.2 mEq/L.
  • Early in therapy, dose adjustments are made as often as every 5 to 7 days to establish the correct dose.
  • Most patients require 900-2400 mg daily in 2-4 divided doses depending on the formulation being used.
  • Patients with
    kidney disease excrete less lithium from the body and, therefore, require lower doses.

Which drugs or supplements interact with lithium?

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Is lithium safe to take if I’m pregnant or breastfeeding?

:

  • Lithium crosses the placenta and has been associated with toxicity in the fetus. Children born to women taking lithium
    during pregnancy have an increased risk of goiter and cardiac anomalies. If possible, lithium should be withheld during the
    first trimester. Women of childbearing age who may require lithium should be counseled about
    becoming pregnant.
  • Lithium is secreted into
    breast milk. Symptoms of lithium toxicity, including changes in the electrocardiogram, have been seen in some breastfed infants, whose mothers were taking lithium. If possible, women taking lithium should not breastfeed their infants.

What else should I know about lithium?

What preparations of lithium are available?

  • Tablets: 300 mg.
  • Tablets (extended release): 300 and 450 mg.
  • Capsules: 150, 300 and 600 mg.
  • Syrup: 300 mg/5 ml
How should I keep lithium stored?

All formulations should be kept at room temperature, 15 C to 30 C (59 F to 86 F).

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