Lithium Carbonate
Antidepressant · Lithium salt
Indications
Mania, manic depressive states, recurrent depression, aggressive and self-mutilating behaviour.
Dosage
Bipolar Disorder: Manic Episodes: Adults & Children: >12 yr: Usual: 1800 mg/day in divided doses given in 3-4 doses. Desired serum levels of 1-1.5 mEq/L.
Adverse Effects
Nausea, diarrhoea. Tremor of hands, muscle weakness. CNS and ECG disturbances. Weight gain, oedema, hypo/hyperthyroidism. Polyuria, polydipsia, skin reactions, GI upset, rhabdomyolysis, arthralgia, myalgia, myoclonus, abnormal reflexes, hyperglycaemia, hypercalcaemia, hypermagnesaemia, thyroid disorders, renal changes, alopecia, sexual dysfunction, scotomata, dysgeusia, anorexia, blurred vision, peripheral circulatory collapse, Raynaud's phenomenon, hypotension, CNS changes, leukocytosis.
Risk Factor (Pregnancy/Lactation)
Pregnancy: Not rated. Lactation: Contraindicated or not recommended. Contraindications: Addison's disease. Renal or cardiac insufficiency, untreated hypothyroidism. Disturbed sodium balance. Diagnosis or family history of Brugada syndrome. Congenital long QT syndrome. Precautions: Treatment should be initiated in hospital. Maintain salt and fluid intake. Epilepsy, risk factors for QT prolongation, family history of cardiac arrest or sudden death. Mild to moderate renal impairment, polyuria, polydipsia. ECT. Monitor patients for suicidal behaviour. Measure serum lithium concentrations regularly. Benign intracranial hypertension; advise patients to report persistent headache and/or visual disturbances. Retitrate if changing formulations. Withdraw gradually. Elderly.
Interactions
Diuretics, NSAIDs, phenytoin, carbamazepine, flupenthixol, haloperidol, diazepam, methyldopa, tetracyclines, ACE inhibitors, angiotensin II receptor antagonists, amiodarone, sodium bicarbonate, metronidazole, SSRIs, TCADs, antipsychotics, phenothiazines, calcium channel blockers, neuromuscular blockers, neostigmine, pyridostigmine, urea, xanthines, calcitonin, anaesthetics, steroids, triptans, drugs that prolong QT interval or lower seizure threshold.
Advice to Patient
Take with meals. Mix syrup form with juice or other flavoured drink before taking. Do not chew or crush extended or slow release tablets or capsules. Contact prescriber immediately if there is unrelieved diarrhoea, drowsiness, vomiting, abrupt changes in weight, fever, changes in urinary volume, muscular tremors, lack of coordination in body movements. Take sufficient amount of fluids (2-3 litres per day) to maintain hydration, unless restricted by the prescriber. Limit caffeine intake. Take diet containing moderate amount of sodium. Taking small frequent meals may help to maintain nutritional status.
Pharmacokinetics
Absorption: Rapid and complete. Metabolism: Not metabolized. Bioavailability: 80% to 100%. Half-life elimination: Pediatric patients 7 to 17 years: t1/2(beta): 27 hours. Adults: 18 to 36 hours; prolonged in elderly patients (approx. 28.5 hours). Time to peak, serum: Immediate release: Approx. 0.5 to 3 hours; Extended release: 2 to 6 hours; Solution: 15 to 60 minutes. Excretion: Urine (primarily; unchanged drug); sweat, saliva, and feces (negligible amounts).
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
Always consult a pharmacist or doctor.