LITHIUM
LITHIUM Overview Information
Lithium is an element. It gets its name from “lithos,” the Greek word for stone, because it is present in trace amounts in virtually all rocks. Lithium works with other elements, drugs, enzymes, hormones, vitamins, and growth factors in the body in many different ways. People use it for medicine.
How does it work?
Exactly how lithium works is unknown, but it might help mental disorders by increasing the activity of chemical messengers in the brain.
Lithium is used for mental illnesses, including
bipolar disorder, depression, and schizophrenia; for eating disorders, including anorexia and bulimia; and for blood disorders, including anemia and low white-cell count (neutropenia).Lithium is also used for headache,
alcoholism, epilepsy, diabetes, liver disease, kidney disorders, arthritis, a skin condition called seborrhea, and overactive thyroid. Other uses include treatment of asthma, Huntington’s disease, Graves’ disease, herpes simplex, a movement disorder called tardive dyskinesia, Tourette’s syndrome, cyclical vomiting, Meniere’s disease, a tingling or “crawling” sensation in the skin (paresthesias), and aggressive behavior in people with attention deficit-hyperactivity disorder (ADHD).How does it work?
Exactly how lithium works is unknown, but it might help mental disorders by increasing the activity of chemical messengers in the brain.
LITHIUM Uses & Effectiveness 
Effective for:
- Bipolar disorder (manic-depressive disorder).
Likely Effective for:
Possibly Effective for:
- Schizophrenia and related mental disorders. Lithium is usually used in combination with antipsychotic drugs when it is used for these disorders. However, sometimes lithium is given alone.
- Impulsive aggressive behavior associated with attention-deficit hyperactivity disorder (ADHD).
- Alcohol dependence.
- Blood cell disorders.
- Other conditions.
More evidence is needed to rate the effectiveness of lithium for these uses.
LITHIUM Side Effects & Safety
Lithium seems to be safe for most people when taken appropriately with careful monitoring by a healthcare provider. Lithium carbonate and lithium citrate have been approved by the U.S. Food and Drug Administration (FDA). But not enough is known about the safety of lithium orotate. Avoid using lithium orotate until more is known.
Lithium can cause nausea, diarrhea, dizziness, muscle weakness, fatigue, and a dazed feeling. These unwanted side effects often improve with continued use. Fine tremor,
frequent urination, and thirst can occur and may persist with continued use. Weight gain and swelling from excess fluid can also occur. Lithium can also cause or make skin disorders such as acne, psoriasis, and rashes worse. The amount of lithium in the body must be carefully controlled and is checked by blood tests.Special Precautions & Warnings:
Pregnancy and breast-feeding: Lithium can poison a developing baby (fetus) and can increase the risk of birth defects, including heart problems. However, when the benefits of giving lithium to the mother outweigh the risks to the fetus, lithium may be given by a healthcare provider, as long as there is careful monitoring.
Lithium treatment is UNSAFE in women who are breast-feeding. Lithium can enter breast milk and cause unwanted side effects in a nursing infant.
Heart disease: Lithium may cause irregular heart rhythms. This may be a problem, especially for people who have heart disease.
Kidney disease: Lithium is removed from the body by the kidneys. In people with kidney disease, the amount of lithium that is given might need to be reduced.
Surgery: Lithium might change levels of serotonin, a chemical that affects the central nervous system. There is some concern that lithium might interfere with surgical procedures that often involve anesthesia and other drugs that affect the central nervous system. Lithium use should be stopped, with the approval of a healthcare provider, at least two weeks before a scheduled surgery.
Thyroid disease: Lithium might make thyroid problems worse.
LITHIUM Interactions
- Medications for depression (Antidepressant drugs) interacts with LITHIUMLithium increases a brain chemical called serotonin. Some medications for depression also increase the brain chemical serotonin. Taking lithium along with these medications for depression might increase serotonin too much and cause serious side effects including heart problems, shivering, and anxiety. Do not take lithium if you are taking medications for depression.
Some of these medications for depression include fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), amitriptyline (Elavil), clomipramine (Anafranil), imipramine (Tofranil), and others. - Medications for depression (MAOIs) interacts with LITHIUMLithium increases a chemical in the brain. This chemical is called serotonin. Some medications used for depression also increase serotonin. Taking lithium with these medications used for depression might cause there to be too much serotonin. This could cause serious side effects including heart problems, shivering, and anxiety.
Some of these medications used for depression include phenelzine (Nardil), tranylcypromine (Parnate), and others.
Moderate Interaction Be cautious with this combination
- Dextromethorphan (Robitussin DM, and others) interacts with LITHIUMLithium can affect a brain chemical called serotonin. Dextromethorphan (Robitussin DM, others) can also affect serotonin. Taking lithium along with dextromethorphan (Robitussin DM, others) might cause too much serotonin in the brain and serious side effects including heart problems, shivering, and anxiety could result. Do not take lithium if you are taking dextromethorphan (Robitussin DM, and others).
- Medications for high blood pressure (ACE inhibitors) interacts with LITHIUMSome medications for high blood pressure can increase lithium levels in the body. Taking lithium along with some medications for high blood pressure might cause too much lithium to be in the body.
Some medications for high blood pressure include captopril (Capoten), enalapril (Vasotec), lisinopril (Prinivil, Zestril), ramipril (Altace), and others. - Medications for high blood pressure (Calcium channel blockers) interacts with LITHIUMLithium is commonly used to help fix chemical imbalances in the brain. Some medications for high blood pressure might increase the side effects of lithium, and decrease the amount of lithium in the body.
Some medications for high blood pressure include nifedipine (Adalat, Procardia), verapamil (Calan, Isoptin, Verelan), diltiazem (Cardizem), isradipine (DynaCirc), felodipine (Plendil), amlodipine (Norvasc), and others. - Medications used to prevent seizures (Anticonvulsants) interacts with LITHIUMMedications used to prevent seizures affect chemicals in the brain. Lithium is commonly used to help fix chemical imbalances in the brain. Taking lithium along with some medications used for seizures might increase the side effects of lithium.
Some medications used to prevent seizures include phenobarbital, primidone (Mysoline), valproic acid (Depakene), gabapentin (Neurontin), carbamazepine (Tegretol), phenytoin (Dilantin), and others. - Meperidine (Demerol) interacts with LITHIUMLithium increases a chemical in the brain called serotonin. Meperidine (Demerol) can also increase serotonin in the brain. Taking lithium along with meperidine (Demerol) might cause too much serotonin in the brain and serious side effects including heart problems, shivering, and anxiety.
- Methyldopa (Aldomet) interacts with LITHIUMTaking methyldopa might increase the effects and side effects of lithium. Do not take lithium if you are taking methyldopa unless prescribed by your healthcare professional.
- Methylxanthines interacts with LITHIUMTaking methylxanthines can increase how quickly the body gets rid of lithium. This could decrease how well lithium works.
Methylxanthines include aminophylline, caffeine, and theophylline. - Muscle relaxants interacts with LITHIUMLithium might increase how long muscle relaxants work. Taking lithium along with muscle relaxants might increase the effects and side effects of muscle relaxants.
Some of these muscle relaxants include carisoprodol (Soma), pipecuronium (Arduan), orphenadrine (Banflex, Disipal), cyclobenzaprine, gallamine (Flaxedil), atracurium (Tracrium), pancuronium (Pavulon), succinylcholine (Anectine), and others. - NSAIDs (Nonsteroidal anti-inflammatory drugs) interacts with LITHIUMNSAIDs are anti-inflammatory medications used for decreasing pain and swelling. NSAIDs might increase lithium levels in the body. Taking lithium along with NSAIDs might increase the risk of lithium side effects. Avoid taking lithium supplements and NSAIDs at the same time.
Some NSAIDs include ibuprofen (Advil, Motrin, Nuprin, others), indomethacin (Indocin), naproxen (Aleve, Anaprox, Naprelan, Naprosyn), piroxicam (Feldene), aspirin, and others. - Phenothiazines interacts with LITHIUMTaking phenothiazines along with lithium might decrease the effectiveness of lithium. Lithium might also decrease the effectiveness of phenothiazines.
Some phenothiazines include chlorpromazine (Thorazine), fluphenazine (Prolixin), trifluoperazine (Stelazine), thioridazine (Mellaril), and others. - Tramadol (Ultram) interacts with LITHIUMTramadol (Ultram) can affect a chemical in the brain called serotonin. Lithium can also affect serotonin. Taking lithium along with tramadol (Ultram) might cause too much serotonin in the brain causing confusion, shivering, stiff muscles and other side effects.
- Water pills (Loop diuretics) interacts with LITHIUMSome “water pills” can increase how much sodium the body gets rid of in the urine. Decreasing sodium in the body can increase lithium levels in the body and increase the effects and side effects of lithium.
- Water pills (Thiazide diuretics) interacts with LITHIUMTaking lithium with some “water pills” can increase the amount of lithium in the body. This can cause serious side effects. Talk to your healthcare provider if you are taking lithium before taking “water pills.”
Some types of “water pills” include chlorothiazide (Diuril), hydrochlorothiazide (HydroDIURIL, Esidrix), indapamide (Lozol), metolazone (Zaroxolyn), and chlorthalidone (Hygroton).
Minor Interaction Be watchful with this combination
- Pentazocine (Talwin) interacts with LITHIUMLithium increases a brain chemical called serotonin. Pentazocine (Talwin) also increases serotonin. Taking lithium along with pentazocine (Talwin) might cause too much serotonin in the body. Taking lithium along with pentazocine (Talwin) might cause serious side effects including heart problems, shivering, and anxiety. Do not take lithium supplements if you are taking pentazocine (Talwin).
LITHIUM Dosing
The following doses have been studied in scientific research:
BY MOUTH:
- For acute manic episodes: 1.8 g or 20-30 mg per kg of lithium carbonate per day in 2-3 divided doses. Some healthcare providers begin therapy at 600-900 mg per day and gradually increase the dose.
- For bipolar disorder and other psychiatric conditions: The usual adult dose is 900 mg to 1.2 g per day in 2-4 divided doses. 24-32 mEq of lithium citrate solution, given in 2-4 divided doses daily, has also been used. Doses usually should not exceed 2.4 g of lithium carbonate or 65 mEq lithium citrate daily. For children, 15-60 mg per kg (0.4-1.6 mEq per kg) per day in divided doses has been used.
Lithium may be given as a single daily dose, but is usually given in divided doses to lessen side effects.
Stopping lithium therapy suddenly increases the chance that symptoms of bipolar disorder will return. The dose of lithium should be reduced gradually over at least 14 days.
There is no recommended dietary allowance (RDA) for lithium. A provisional RDA of 1 mg per day for a 70 kg adult has been suggested.
