RevisePsych

Lithium

• Treats acute mania, prophylaxis in bipolar affective disorder

• Narrow therapeutic range with need for plasma level monitoring

• Excreted unchanged by kidney (follows sodium in reabsorption at proximal tubules)

• Levels peak after 1-2 hours (take lithium level after 12)

• Abrupt withdrawal may cause mood elevation

• Teratogen

 

Side-effects of lithium:

- diuresis

- tremor

- weight gain

- metallic taste

- weakness/fatigue

- thyroid enlargement

- hypothyroidism

- nephrogenic diabetes insipidus

- ECG changes (elongated QRS, T wave flattening)

- chronic renal toxicity (rare)

 

Signs of toxicity: nausea, vomiting, coarse tremor, ataxia, muscle twitching, confusion, convulsions, coma