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  Lithium

Pharmacokinetics | Indications | Routes of Administration and Dosage | Contra Indications | Precautions | Interactions | Brand Names


Systems Central nervous system.
Category Antimanic[mood stabilizer]


Pharmacokinetics

Lithium is given orally. It is well absorbed and gets distributed throughout the total body water. The drug is excreted in the urine.Most of the filtered lithium is reabsorbed in the proximal convoluted tubule. Renal clearance is proportional to its plasma clearance. It decreases the sodium re-absorption leading to sodium depletion. Hence patients should maintain adequate salt and water intake.Since the margin of safety is narrow monitoring the serum lithium concenration is esssential for optimal therapy.Toxic symptoms occur frequently when serum levels exceed 1.5 mEq/L.



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Indications

Lithium is used to treat the manic stage of bipolar disorder (manic-depressive illness). Manic-depressive patients often experience severe mood changes, ranging from an excited or manic state (for example, unusual anger or irritability or a false sense of well-being) to depression or sadness. Lithium is used to reduce the frequency and severity of manic states. Lithium may also reduce the frequency and severity of depression in bipolar disorder. It is not known how lithium acts to stabilize a person's mood. It does act on the central nervous system. It helps to have more control over emotions .



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Routes of Administration and Dosage

The starting dose is usually 600 mg/day and gradually increased to yield plasma therapeutic concentrations.Generally 900-1800 mg/day is required.



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Contra Indications

It is contraindicated in renal disease, cardiac disease, electrolyte imbalance and major surgery.



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Precautions

Allergies: May occur with lithium therapy. Diet: low-sodium or low-salt diet could lead to serious side effects. Pregnancy : Lithium is not recommended for use during pregnancy, especially during the first 3 months. Studies have shown that lithium may rarely cause thyroid defects and cardiac or vascular defects in the baby. It has also been shown to cause muscle weakness and severe drowsiness in newborn babies of mothers taking lithium near the time of delivery. Breast-feeding: Lithium passes into the breast milk. It has been reported to cause adverse effects such as muscle weakness, hypothermia, and cardiac disorders in nursing babies.



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Interactions

Antipsychotics : Blood levels of both drugs may fluctuate, increasing the chance of serious adverse effects. Diuretics and anti-inflammatory drugs( except narcotics) can produce elevated blood levels of lithium. Drugs for asthma, bronchitis, emphysema, sinusitis, or cystic fibrosis that contains Calcium iodide, Iodinated glycerol or Potassium iodide : adverse effects on the thyroid may occur.



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Brand Names

INTALITH (INTAS), LALITHIUM (LA PHARMA), LICAB (TORRENT), LIBTON (PACE), LITHIUM (MICRO LABS), LITHOSUN (SUN PHARMA)



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Pharmacokinetics | Indications | Routes of Administration and Dosage | Contra Indications | Precautions | Interactions | Brand Names

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