Lithium (Oral)

Lithium treats bipolar disorder for patients who are manic-depressive.

Overview

Lithium is prescribed in the treatment of mania when it takes place for patients who have manic-depressive bipolar disorder. It can be used daily to reduce the likelihood, severity, and frequency of manic occurrences. Patients who may be manic-depressive can experience mood changes that can be severe, ranging from a manic state (unusual excitement, irritability, anger, or sense of wellness) to sadness or depression.

While it is not completely certain how lithium aids in the stabilization of people's moods, it is known that lithium impacts the central nervous system. It gives people a chance to have a higher level of control over their emotions and aids them in better coping mechanisms with issues that can transpire from day-to-day living.

It is highly important that you are aware of all of the potential effects that can take place from taking lithium. It is also essential that your family members are all aware of the effects as well. Side effects are dependent on your unique condition, the amount of medication you take, and your individual response to the medication. It is also highly important to be aware of when you should contact your doctor if you experience issues in the effectiveness of this medication.

Lithium can only be obtained in the subsequent forms of dosage:

  • Tablet
  • Tablet (extended release)
  • Syrup
  • Solution
  • Capsule

Lithium is manufactured under the following US brand names:

  • Lithobid
  • Eskalith-CR
  • Eskalith

Conditions treated

Type of medicine

  • Lithium compounds

Side Effects

In addition to the benefits medications may provide, they can also trigger side effects that may be undesirable. While it is not typical for each one of the following side effects will take place, if they do take place they could require medical care.

Consult with your physician right away if the side effects below take place:

Less common side effects (medical care required):

  • Poor memory, lack of awareness, or confusion
  • Fainting
  • Slow or fast heartbeat
  • Urination frequency increase
  • Thirst increase
  • Pulse irregularity
  • Stiffness of legs or arms
  • Difficulty breathing (specifically during exercise or hard work)
  • Unusual weakness or tiredness
  • Weight gain

Rare side effects (medical care required):

  • Blue color of the toes and fingers and pain
  • Coldness of the legs and arms
  • Dizziness
  • Eye pain
  • Headache
  • Ear noises
  • Vision issues

Occurrence rate unknown (medical care required)

  • Rough, dry skinoss of hair
  • Pulse racing, pounding, irregularity, or quickness
  • Heartbeat racing, pounding, irregularity, or quickness
  • Loss of hair
  • Hoarseness
  • Lightheadedness
  • Mental depression
  • Coldness sensitivity
  • Breath shortness
  • Swelling of lower legs or feet
  • Swelling of neck
  • Excitement (unusual)

Seek emergency assistance right away if you experience any of the symptoms below of overdose.

Overdose symptoms:

  • Vision blurriness
  • Unsteadiness or clumsiness
  • Seizures (convulsions)
  • Diarrhea
  • Drowsiness
  • Urine amount increase
  • Coordination lack of
  • Appetite loss
  • Weakness of the muscles
  • Vomiting or nausea
  • Ear ringing
  • Speech slurred
  • Severe trembling

Certain side effects could take place when taking lithium that typically will not require medical care. These particular side effects will likely disappear after your body becomes more adjusted to taking lithium. In addition, your medical care professional can likely notify you of other methods to decrease or counteract some side effects. Consult with your medical care professional if the side effects below become prolonged, troublesome, or if you have concerns or questions regarding them.

Less common side effects (medical care not required):

  • Skin rash or acne
  • Pressure within stomach or bloated sensation
  • Twitching of the muscles (slight)

Additional side effects not listed above can also take place for certain patients. If other side effects are observed, consult with your medical care professional.

Contact your doctor if you are looking for any kind of medical advice in regards to potential side effects of lithium. The Food and Drug Administration also accepts consumer side effect reports, and reports can be sent by contacting them at 1-800-FDA-1088.

Dosage

Lithium must be taken exactly as instructed by your physician. Never take a dose of lithium that is less or more than instructed. Do not take this medication less or more frequently, and never take lithium for a longer duration than prescribed. Doing so could cause side effects to be increased.

Patients may need to take lithium for a period of a few weeks prior to the symptoms begin to subside. Consult with your physician with any concerns or questions you may have.

Ensure that your physician is aware if you are on low-salt or low-sodium diet. Not enough salt in that could cause more severe side effects to take place.

Consult with your physician regarding how much fluid you should be taking along with your dose of this medication. Certain patients may need to drink additional fluids daily along with the medication.

Never chew, crush, or break the extended release tablet. Swallow it whole.

Only use a marked medicine cup, oral syringe, or measuring spoon. A metal teaspoon can have varied amounts and may not be exactly one teaspoon.

Lithium can come in many varied forms. Each form will have a different dose, and each should be taken at specific times daily. Never change the medication you are taking without first consulting with your physician.

For this medication to work as it should, patients should take it daily in regularly occurring doses as recommended by your physician. This will maintain a constant quantity of lithium within the blood. Patients should try not to miss a single dose and should not discontinue use of the medication, even if symptoms subside. This will help to maintain a constant amount of lithium in the blood.

Only take the brand of medication that your physician instructed. Other brands may work differently.

Different patients will be directed to take a unique dose of lithium based on their unique medical needs. Follow the instructions given by your doctor or the instructions on the medication label. The directions included here will summarize typical doses of lithium only. If you were prescribed a dose that differs from the information here, do not adjust it unless instructed to do so by your physician.

The amount of medication you are prescribed take will depend directly on how strong the prescription is. In addition, the total number of doses that you take every day, the allotted time between each dose, and the total duration for which lithium is taken is dependent on the medical issue for which the medication is used.

For tablets, solution, and capsule form (oral forms of dosage):

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    • For treatment of acute mania:

O Adults: Take 600 mg (milligrams) or 10 mL (milliliters) three times daily. Your physician may alter the dosage instructions if required.
O Children: Pediatrician must determine dosage information for your child.

    • For treatment of mania (long-term):

O Adults: Take 300 mg (milligrams) or 5 mL (milliliters) 3-4 times daily. Your doctor may choose to change the prescribed dose depending on how your body reacts to the medication.
O Children: Physician must determine dose.

For extended-release tablets (oral form of dosage):

    • For treatment of acute mania:

O Adults: Take 900 mg (milligrams) twice daily, or a dose of 600 mg 3x daily.
O Adolescents and children over age 12: Physician must determine dosage information based on patient's unique medical needs.
O Children under age 12: It is not suggested for children to take this medication.

    • For treatment of mania (long-term):

O Adults: Take 600 mg (milligrams) twice each day, or three times daily (no more than 1200 mg daily)
O Adolescents and children over age 12: Physician must calculate unique dosage information.
O Children under age 12: It is not recommended for children to ingest lithium.

If a dose of this medication is accidentally skipped, it must be taken as soon as the patient recognizes that the missed dose was skipped. However, if it is nearer to the scheduled next dose, the patient may return to the original dosage schedule and allow the skipped dose to remain missed. Never take a double dose of lithium.

Interactions

Some medications should not ever be taken at the same time, however in certain circumstances two medications can be combined despite the possibility that an interaction may take place. Under these circumstances, your physician may choose to adjust the dose, or they may request other precautions to be taken to protect you as a patient. While on lithium, it is imperative that your medical care provider is aware if you are on any of the following medications. The following list of interactions was selected due to the possible significance. This list is not all-inclusive.

Taking lithium with any of the medications below is not typically suggested, however certain circumstances may require the combination. If your physician decides both medications can best treat your needs, they may decide to decrease the frequency or dosage instructions for either medication.

  • Zuclopenthixol
  • Zotepine
  • Zofenopril
  • Ziprasidone
  • Xipamide
  • Vortioxetine
  • Vilazodone
  • Valsartan
  • Valdecoxib
  • Tryptophan
  • Trimeprazine
  • Triflupromazine
  • Trifluoperazine
  • Trichlormethiazide
  • Trazodone
  • Trandolapril
  • Tramadol
  • Torsemide
  • Tolmetin
  • Tolfenamic Acid
  • Tiaprofenic Acid
  • Tiapride
  • Thiothixene
  • Thioridazine
  • Thioproperazine
  • Thiopropazate
  • Tenoxicam
  • Telmisartan
  • Suprofen
  • Sulpiride
  • Sulindac
  • Spironolactone
  • Spirapril
  • Sodium Salicylate
  • Sibutramine
  • Sertindole
  • Salsalate
  • Salicylic Acid
  • Safinamide
  • Rofecoxib
  • Risperidone
  • Remoxipride
  • Ramipril
  • Quinapril
  • Proquazone
  • Propyphenazone
  • Promethazine
  • Promazine
  • Proglumetacin
  • Prochlorperazine
  • Pranoprofen
  • Polythiazide
  • Piroxicam
  • Piretanide
  • Pipotiazine
  • Pipamperone
  • Pimozide
  • Piketoprofen
  • Phenylbutazone
  • Phenelzine
  • Perphenazine
  • Perindopril
  • Periciazine
  • Penfluridol
  • Parecoxib
  • Palonosetron
  • Oxyphenbutazone
  • Oxycodone
  • Oxaprozin
  • Olmesartan
  • Olanzapine
  • Nimesulide Beta Cyclodextrin
  • Nimesulide
  • Niflumic Acid
  • Nepafenac
  • Naproxen
  • Nabumetone
  • Morniflumate
  • Molindone
  • Moexipril
  • Mirtazapine
  • Milnacipran
  • Metolazone
  • Methylene Blue
  • Methyclothiazide
  • Methotrimeprazine
  • Mesoridazine
  • Meperidine
  • Melperone
  • Meloxicam
  • Mefenamic Acid
  • Meclofenamate
  • Lumiracoxib
  • Loxoprofen
  • Loxapine
  • Losartan
  • Lornoxicam
  • Lorcaserin
  • Lisinopril
  • Linezolid
  • Levomilnacipran
  • Ketorolac
  • Ketoprofen
  • Irbesartan
  • Indomethacin
  • Indapamide
  • Ibuprofen
  • Hydroflumethiazide
  • Hydrochlorothiazide
  • Haloperidol
  • Granisetron
  • Furosemide
  • Fosinopril
  • Flurbiprofen
  • Fluphenazine
  • Flupenthixol
  • Flufenamic Acid
  • Floctafenine
  • Feprazone
  • Fepradinol
  • Fentanyl
  • Fenoprofen
  • Fenbufen
  • Felbinac
  • Etoricoxib
  • Etofenamate
  • Etodolac
  • Ethopropazine
  • Ethacrynic Acid
  • Eprosartan
  • Enalaprilat
  • Enalapril
  • Duloxetine
  • Droxicam
  • Droperidol
  • Donepezil
  • Domperidone
  • Dolasetron
  • Dipyrone
  • Diflunisal
  • Diclofenac
  • Diazoxide
  • Dexketoprofen
  • Dexibuprofen
  • Desvenlafaxine
  • Clozapine
  • Clonixin
  • Cilazapril
  • Choline Salicylate
  • Chlorthalidone
  • Chlorprothixene
  • Chlorpromazine
  • Chlorothiazide
  • Celecoxib
  • Carprofen
  • Captopril
  • Canrenoate
  • Candesartan
  • Buprenorphine
  • Bumetanide
  • Bufexamac
  • Bromperidol
  • Bromfenac
  • Benzthiazide
  • Bendroflumethiazide
  • Benazepril
  • Bemetizide
  • Azosemide
  • Azilsartan Medoxomil
  • Aspirin
  • Amtolmetin Guacil
  • Amoxapine
  • Amitriptyline
  • Almotriptan
  • Alclofenac
  • Alacepril
  • Acetophenazine
  • Acemetacin
  • Aceclofenac

Taking lithium in addition to any of the medications below could cause there to be a greater chance of some side effects taking place, but the combination of both medications could prove to be the most optimal form of treatment for your circumstances. If your doctor chooses to prescribe both medications the same time, they may adjust the frequency or amount of either one or both of the medications you are taking.

  • Zimeldine
  • Yohimbine
  • Verapamil
  • Succinylcholine
  • Sertraline
  • Paroxetine
  • Metronidazole
  • Mazindol
  • Lactulose
  • Fluvoxamine
  • Fluoxetine
  • Femoxetine
  • Escitalopram
  • Diltiazem
  • Clovoxamine
  • Citalopram
  • Cisplatin
  • Carbamazepine
  • Calcitonin

Some prescription drugs should not be taken near or around mealtime as the likelihood of interactions taking place can increase when eating particular kinds of food. The use of tobacco or alcohol in addition to certain medications could cause interactions to take place. The interactions listed below are chosen according to how significant the interaction may be. This list is not entirely all-inclusive.

Patients with other medical issues could experience effectiveness in the use of lithium. Be sure to inform your physician of any medical issues you may have, specifically:

  • Heart disorder (Brugada syndrome), including family history
  • Urination decrease
  • Diarrhea (prolonged)
  • Infection (with fever, severe)
  • Kidney disease 'take caution, effects could be increased due to slower excretion of the medication from the human body
  • Sweating (prolonged)
  • Vomiting (prolonged) could increase chance of side effects taking place
  • Dehydration (severe)
  • Blood vessel or heart disease
  • Low sodium levels within blood (hyponatremia)
  • Weakness of the muscles (severe)
  • Physical condition weakened ' patients with such conditions should not take lithium
  • Brain disease (Encephalopathic syndrome)
  • Thyroid or other goiter issues
  • Nervous system issues' take caution, conditions may be made worse

Warnings

It is imperative that your physician monitor your progress regularly while on lithium to ensure this medication is working the way that it should. Urine and blood testing may be required to ensure undesired side effects are not taking place.

Taking lithium while pregnant can cause harm to the unborn baby. Be sure to have an effective type of birth control in place to ensure you will not become pregnant. If you suspect that you have conceived while taking this medication, inform your physician immediately.

Discontinue use of this medication and contact your physician immediately if you experience issues with coordination or muscle control, unsteadiness, tremors, muscle weakness, drowsiness, vomiting, or diarrhea.

Ensure your physician is aware if you have been diagnosed with Brugada syndrome, a heart disorder. This can be a deadly syndrome and immediate emergency care is required if it occurs. Inform your physician right away or the emergency medical department if you have difficulty breathing; lightheadedness; fainting (unexplained); uneven, pounding, or quick heartbeat.

A brain issue (Encephalopathic syndrome) can take place for some patients on lithium at the same time as Haldol® (haloperidol). Consult with your physician immediately if you experience unusual weakness or tiredness, body movements that are uncontrolled, speaking difficulty, drowsiness, confusion, or a fever.

Some individuals can experience drowsiness, dizziness, or a lack of alertness (more than usual). Be sure that you are aware of your own personal reaction to lithium prior to operating machinery, driving, or doing other activities that could potentially be dangerous if not alert or dizzy.

Exercise additional caution while in excessively hot weather and while performing activities that could cause excessive sweating, such as exercising, saunas, or hot baths. For patients with illnesses or infections that could cause muscle weakness, shakiness, diarrhea, vomiting, or heavy sweating, consult with your physician immediately. Patients who lose too much salt or water from the body could experience severe side effects from the use of lithium.

Patients taking lithium should not attempt to diet in order to lose weight prior to consulting with their physician. Incorrect dieting could trigger an excess of salt or water from the body, causing severe side effects from this medication.

Other medications should not be taken concurrently with lithium unless previously approved by your physician. This refers to both nonprescription and nonprescription medications as well as vitamin and herbal supplements.

When deciding whether or not a medication is right for you, compare the dangers of taking the medication against the benefits it could provide. This choice must be made carefully with your physician. For lithium in particular, consider the following aspects prior to taking this medication.

Inform your physician if you have experienced allergic or unusual reactions to lithium or any other medication. Also inform your doctor if you have previously had other kinds of allergies, such as to animals, preservatives, dyes, or foods. When taking products that are not prescription, read the package or label directions carefully.

Children under age 12 should not take lithium. Current research has not yet examined whether or not age impacts effects of lithium for patients under age 12. It has not yet been determined whether or not lithium is both effective and safe for children under 12.

Research on side effects of lithium and the elderly population specifically has not yet been conducted. However, geriatric patients typically have a higher likelihood of having kidney and heart issues that are age relate. These impacts could necessitate a dose adjustment for elderly patients taking lithium.

Pregnant women should avoid taking lithium. Research has proven that there is a danger to the fetus. However, life-threatening circumstances or a severe disease may outweigh the risk in certain cases.

Research has not yet determined if there is a potential risk to the infant if the mother takes lithium while breastfeeding. The possible benefits should be compared against the potential dangers prior to the mother taking lithium while breastfeeding.

Storage

Keep this medication in a sealed container away from freezing or hot temperatures, direct light, and moisture. Always keep far from children's reach.

Never keep medication that is no longer needed or expired.

Consult with your physician regarding how to properly dispose of unused lithium.

Summary

Lithium is recommended for the treatment of mania for patients who have manic-depressive bipolar disorder. It can be taken daily to lower the likelihood, severity, and frequency of manic episodes. Patients who are manic-depressive can go through mood changes that can be extreme, ranging from a manic state (uncommon excitement, irritability, anger, or sense of wellness) to unhappiness or despair.

While it is not entirely evident how lithium helps with the stabilization of moods, it is known that lithium influences the central nervous system. It allows individuals to have a greater level of control over their day-to-day emotions.

It is imperative that patients and family members of the patients are aware of all of the possible side effects that can transpire from taking lithium. Side effects are reliant on on your individual health condition, the quantity of medication you are prescribed, and your individual reaction to the medication. Patients must also be familiar with when they should contact the physician if they experience negative side effects of issues with the effectiveness of lithium.