LITHIUM FACT SHEET

This information is not a replacement for full discussion of risks and benefits with your doctor.

Other Names: Lithium carbonate, Priadel.

Principal Uses: Prophylaxis and treatment of mania/hypomania/bipolar disorder, recurrent depression/bipolar depression, augmentation (to increase effect ) of antidepressants, some protection against antidepressant-induced hypomania.

Dose: Comes in 250mg and 400mg. Start at lower dose and aim for plasma levels between 0.6-1.2mmol/l (bloods for levels taken ~12hrs after last dose-usually in the morning) Doses of 800mg- 1500mg/day usually needed.

Cost: Fully subsidised.

Some Possible Side effects: Minimal side effects for many people. Tend to be related to plasma level. Mild gastrointestinal symptoms can occur initially-usually this passes.
Fine hand tremor, mild thirst, polyuria, skin conditions (psoriasis, acne) may get worse. Longer term: hypothyroidism (easily treated with thyroid hormone replacement) increased risk of hyperparathyroidism (patients on long term Lithium treatment should have calcium levels monitored). Kidney damage in a small number of people especially if used long term ( monitor kidney function).

Can be dangerous in overdose.

Interactions: Diuretics and non-steroidal anti-inflammatory medications increase Lithium levels Other interactions are possible with Carbamazepine, SSRI’s, ACE inhibitors, Angiotensin 2 antagonists, cardioactive drugs (digoxin, diltiazem, verapamil ), haloperidol and alcohol – discuss with your doctor.

Use in Pregnancy: Category D

There is a positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).

Use in breast feeding: Category L4
There is positive evidence of risk to a breastfed infant , or to the breast milk production, but the benefits to the breastfeeding mother may be acceptable despite the risk to the infant (eg if the drug is needed in a life threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).

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