Generic
Lithium Carbonate
4 brands available in the market
At a glance
Lithium Carbonate is used in the treatment of bipolar disorder and mania. It reduces the frequency and intensity of manic episodes and helps stabilize mood.
Description
The therapeutic mechanism of lithium is not fully known. It inhibits enzymes such as glycogen synthase kinase 3 and inositol phosphatases, and modulates glutamate receptors. Lithium Carbonate alters intraneuronal metabolism of catecholamines and sodium transport in neurons and muscle cells.
Indications
- Mania - treatment and prophylaxis
- Bipolar disorder - treatment and prophylaxis
- Recurrent unipolar depression
Therapeutic class
Anti-manic Drugs
Pharmacological class
Mood Stabilizer
Pharmacology
Lithium inhibits glycogen synthase kinase 3 and inositol phosphatases, modulates glutamate receptors, and alters catecholamine metabolism in neurons.
Mechanism of action
Stabilizes mood by suppressing abnormal and excessive activity of nerve cells in the brain.
Dosage
Adult Dose (Oral):
- Mania/Bipolar/Recurrent depression: 400-1,200 mg/day in 1-2 divided doses
- Serum lithium monitoring: 0.6-1.2 mEq/L (max 1.5 mEq/L)
- Renal impairment: CrCl 10-50: 50-75% of normal dose; CrCl <10: 25-50%
Administration
- Take with food
- Take at the same time each day
- Follow label directions
Missed dose
Not generally applicable (long-term use); consult doctor if needed.
Side effects
Common Side Effects:
- Tremor
- Slurred speech
- Uncoordinated body movements
- Nausea
- Acne
- Increased white blood cell count
- Memory impairment
- Hair loss
- Goiter (enlarged thyroid)
- Skin rash
- Increased thirst
- Weight gain
- Polyuria
- Diarrhea
Precautions & warnings
- Monitor lithium blood levels, thyroid, and kidney function regularly
- May cause diarrhea and dehydration; drink plenty of water and use normal amounts of salt
- Inform doctor if starting or stopping a low-salt diet
- Monitor weight during treatment (may cause weight gain)
- Caution when driving or doing activities requiring concentration (may cause drowsiness, tiredness, dizziness)
Contraindications
- Renal insufficiency
- Cardiovascular insufficiency
- Addison's disease
- Untreated hypothyroidism
Drug interactions
- Reduced serum levels with carbonic anhydrase inhibitors, chlorpromazine, sodium preparations, theophylline
- Increased risk of lithium toxicity with ACE inhibitors, angiotensin receptor antagonists, loop diuretics, metronidazole, phenytoin (potentially fatal)
- Increased risk of neurotoxicity with carbamazepine, calcium channel blockers, haloperidol
Food interactions
Alcohol consumption with Lithium Carbonate is unsafe.
Use in pregnancy
Use in Pregnancy: Lithium Carbonate is unsafe during pregnancy (Category D); definite evidence of risk to the fetus. Use only in life-threatening situations with doctor's advice.
Pregnancy Category: D — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Lithium Carbonate is probably safe during breastfeeding; limited human data suggests no significant risk to the baby.
Pediatric use
Pediatric dose established (over 12 years)
Geriatric use
Use with caution in elderly (monitor renal function)
Renal / hepatic impairment
Renal Impairment: Caution in kidney disease; dose adjustment needed; not recommended in severe kidney disease.
Hepatic Impairment: Probably safe in liver disease; dose adjustment may not be needed.
Overdose effects
Overdose: discontinue lithium, serum estimations every 6 hours; if serum lithium >4 mmol/L or clinical deterioration, initiate peritoneal or hemodialysis.
Storage conditions
Store below 30°C, away from light and moisture; keep out of reach of children.
Chemical structure
Lithium Carbonate