Lithium

Brand Names

Lithium, Eskalith, Lithobid

What is Lithium

Lithium is a prescription medicine that related to a class of medications called antimanic agents. Lithium is used to treat and prevent episodes of mania (frenzied, abnormally excited mood) in people with bipolar disorder (manic-depressive disorder; a disease that causes episodes of depression, episodes of mania and other abnormal moods). It works by decreasing abnormal activity in the brain.

Side effects of Lithium

You should inform your doctor if you have such side effects as:

• restlessness
• fine hand movements that are difficult to control
• loss of appetite
• stomach pain or bloating
• gas
• indigestion
• weightgain or loss
• dry mouth
• excessive saliva in the mouth
• tongue pain
• change in the ability to taste food
• swollen lips
• acne
• hair loss
• unusual discomfort in cold temperatures
• constipation
• depression
• joint or muscle pain
• thin, brittle fingernails or hair

There is a list of serious side effects:

• tiredness
• shaking of a part of your body that you cannot control
• muscle weakness, stiffness, twitching, or tightness
• loss of coordination
• diarrhea
• vomiting
• excessive thirst
• frequent urination
• giddiness
• ringing in the ears
• slow, jerky movements
• movements that are unusual or difficult to control
• blackouts
• seizures
• slurred speech
• fast, slow, irregular or pounding heartbeat
• chest tightness
• confusion
• hallucinations (seeing things or hearing voices that do not exist)
• crossed eyes
• painful, cold or discolored fingers and toes
• headache
• pounding noises inside the head
• changes in vision
• paleness
• itching
• rash
• swelling of the eyes, face, lips, tongue, throat, hands, feet, ankles or lower legs

Indication

In general, Lithium is used to treat bipolar disorder, but sometimes it can be used for treating such conditions as:

• Agitation that is not associated with bipolar disorder
• Depression
• Graves' disease (a form of hyperthyroidism)
• Migraine headaches or cluster headaches
• Neutropenia (low levels of neutrophils, a type of white blood cells) that is caused by chemotherapy or other medications
• Syndrome of inappropriate antidiuretic hormone secretion (SIADH), a condition that affects sodium levels in the blood.

Precautions

You should inform your doctor before taking lithium if you have:

• Kidney disease, including kidney failure (renal failure)
• Heartdisease
• Dehydration
• Low sodium levels in your blood (hyponatremia)
• Any allergies, including allergies to food, dyes or preservatives
• Pregnant or are thinking of becoming pregnant
• Breastfeeding
• Are taking any other medicines, including prescription and non-prescription medicines, vitamins and herbal supplements

Dosage forms

Lithium dose for Acute mania

For people with acute mania the recommended starting dose is lithium 600 mg 3 times daily (for immediate-release lithium tablets, capsules or syrup). For extended-release lithium tablets, the recommended starting dose is lithium 900 mg twice daily. Starting at such high lithium doses helps to produce an effective lithium blood level quickly (which is needed to control the severe symptoms of mania), although the risk of lithium side effects and lithium toxicityis also increased.

Lithium dose for Maintenance treatment

Maintenance treatment for bipolar disorder is used when no acute mania or depressionis present. This helps to stabilize the mood, preventing episodes of mania or depression. Maintenance can be thought of as long-term control of bipolar disorder symptoms. If you do not have severe symptoms of bipolardisorder when starting lithium, your healthcare provider may recommend starting with a low lithium dose and slowly increasing it while frequently checking the level of lithium in the blood. This helps prevent lithium toxicity.

Ultimately, your maintenance dose will depend greatly on your lithium blood levels, which is why regular testing is important. Some people may experience relief from their symptoms of bipolar disorder with low lithium blood levels (and are less likely to experience side effects), while others require higher lithium blood levels (and are more likely to experience side effects).