What is a lithium compound used for?
Lithium compounds, also known as lithium salts, are primarily used as a psychiatric medication. This includes the treatment of major depressive disorder that does not improve following the use of other antidepressants, and bipolar disorder. In these disorders, it reduces the risk of suicide. Lithium is taken by mouth.
Why is lithium used for bipolar disorder?
Lithium (medication) Lithium is used primarily for bipolar disorder. It is sometimes used when other treatments are not effective in a number of other conditions, including major depression, schizophrenia, disorders of impulse control, and some psychiatric disorders in children. In mood disorders, of which bipolar disorder is one,...
How effective is lithium in treating cyclothymic disorder?
Effective treatment for persons with severe cyclothymic disorder. Lithium reduces the incidence of suicide in persons with bipolar I disorder 6-7X's. Nice work! You just studied 21 terms! Now up your study game with Learn mode. Lithium is used for acute-phase illness as well as for prevention of recurrent manic and depressive episodes.
When was lithium first used in medicine?
In the nineteenth century, lithium was used in people who had gout, epilepsy, and cancer. Its use in the treatment of mental disorders began in 1948 by John Cade in Australia. It is on the World Health Organization's List of Essential Medicines.
What disorder is commonly treated with lithium?
Lithium is used to treat mania that is part of bipolar disorder (manic-depressive illness). It is also used on a daily basis to reduce the frequency and severity of manic episodes.
What types of disorders have salts of lithium been used to treat?
Lithium treatment remains the “gold standard” of treatment for preventing recurrences in bipolar disorder, both types I (with mania and major depression) and II (with depression and hypomania). It also has evidence of effectiveness for preventing suicidal behavior in patients with bipolar or major depressive disorder.
Is lithium used for anything other than bipolar?
People use lithium supplements for alcohol use disorder, Alzheimer disease, depression, and many other conditions, but there is no good scientific evidence to support any of these uses. Lithium carbonate and lithium citrate are approved by the U.S. FDA as prescription drugs for bipolar disorder.
What disorder is lithium carbonate used for?
This medication is used to treat manic-depressive disorder (bipolar disorder). It works to stabilize the mood and reduce extremes in behavior by restoring the balance of certain natural substances (neurotransmitters) in the brain.
Is lithium used for schizophrenia?
Clinically, lithium has also been used for treating severe psychosis symptoms, and lithium alone or lithium augmentation of antipsychotic medications is proposed as an effective treatment for some patients with schizophrenia24,31.
Is lithium still used for bipolar disorder?
Lithium has been and continues to be the mainstay of bipolar disorder (BD) pharmacotherapy for acute mood episodes, switch prevention, prophylactic treatment, and suicide prevention.
What's lithium used for?
Lithium is a chemical element found in nature that is sometimes used in medicines to treat certain mental illnesses, such as bipolar disorder. Lithium can treat acute mania, or 'highs', and help with longer-term mood stabilisation. It's also used in treating some types of depression and other types of mental illness.
Is lithium prescribed for depression?
Lithium is only approved for depression associated with bipolar disorder. It might also be effective for other kinds of depression when it's added on to an antidepressant, but more trials are needed. If you're taking an antidepressant and still have symptoms, talk to your doctor about whether adding lithium could help.
Does lithium help with anxiety?
In fact, some patients start feeling less anxious, irritable, and depressed just days after taking low-dose lithium. Despite the evidence supporting the benefits of low-dose lithium, it is still underused as a supplement in psychiatry.
When was lithium first used for bipolar?
The use of lithium in psychiatry goes back to the mid-19th century. Early work, however, was soon forgotten, and John Cade is credited with reintroducing lithium to psychiatry for mania in 1949.
What causes bipolar disorder?
Genes. Bipolar disorder often runs in families, and research suggests that this is mostly explained by heredity—people with certain genes are more likely to develop bipolar disorder than others. Many genes are involved, and no one gene can cause the disorder. But genes are not the only factor.
What is the action of lithium?
Lithium acutely stimulates the NMDA receptor, increasing glutamate availability in the postsynaptic neuron. After chronic administration, lithium induces NMDA downregulation, this way lithium modulates glutamate neurotransmission. In the previous slides we saw how lithium inhibits excitatory neurotransmission.
What is lithium used for?
Lithium controls symptoms of mania and prevents the recurrence of both manic and depressive episodes.
How Does Lithium Work?
It is not understood exactly how lithium works in stabilizing mood. It is clear only that it works on the brain and spinal cord . One recent discovery shows evidence that lithium reduces inflammation in the brain by regulating DHA, an omega-3-fatty acid. Inflammation in the brain has been known to contribute to psychiatric conditions and degenerative diseases.
How long has lithium been used?
Lithium has been used clinically for 70 years, mainly to treat bipolar disorder. Competing treatments and exaggerated impressions about complexity and risks of lithium treatment have led to its declining use in some countries, encouraging this update about its safe clinical use.
When was lithium first used?
Lithium treatment finally received regulatory approval by the US Food and Drug Administration (FDA) in 1970 for treatment of acute mania, and in 1974 as the first—and for many years, the only—approved treatment for prevention of recurrences in bipolar disorder.
What was the first treatment for mania?
In 1949, John Cade (1929–1996), an Australian psychiatrist, serendipitously initiated a new era in psychiatric treatment by using lithium carbonate to treat mania. His use of lithium arose from the hypothesis that major mental illnesses might be associated with deficiencies or excesses of unidentified chemical substances, including accumulations of nitrogenous metabolites. This idea led him to give lithium carbonate to laboratory animals to limit toxicity of test substances including uric acid and noting calming and other behavioral changes. Subsequently, he reported on beneficial effects of treating ten patients with lithium carbonate (a medically accepted, though unproved, treatment for gout) for mania and on risks of discontinuing such treatment (Cade 1949 ). These encouraging initial results are now widely considered a revolutionary discovery, although this innovative and effective treatment was not immediately adopted by psychiatry. As Cade himself observed, “a discovery by an unknown psychiatrist without research training, working in a small hospital for the chronically mentally ill, with primitive techniques and negligible equipment, could not attract much attention” (Cade 1999 ). In addition, several cases of severe, acute intoxication associated with use of lithium salts as a substitute for table salt (sodium chloride) were reported in 1949, and some experience was required to learn how to use lithium safely. This could be achieved by measuring its concentration in blood (Amdisen 1967; Baldessarini 2013; Bauer and Gitlin 2016 ).
How often should you stop taking lithium?
Whenever lithium is discontinued, this should be done gradually, over at least a month at a rate of dose-reduction of 20–25% every 2 weeks or longer. If an acute medical problem requires rapid discontinuation, this needs to be carried out under close medical supervision.
How long does it take for lithium to stabilize?
If a dose is changed, 5–7 days should pass before measuring the blood level to allow tissue distribution to stabilize. Optimal doses of lithium are decided by a clinician, and depend on the patient’s age, general health, type of bipolar disorder, symptom-severity, and frequency of recurrences.
How often should I take lithium?
Lithium should be taken regularly as prescribed. A daily single dose after the evening meal is convenient, preferably with slow-release formulations in relatively young, otherwise healthy patients. This practice can support critically important, long-term treatment-adherence (Malhi et al. 2017 ). For older or infirm patients, and users of high daily doses (over 1200 mg of lithium carbonate [32 mEq]), divided daily doses may be safer. If a dose is missed it is not safe to double the next dose. If the brand or salt-form of lithium needs changing, this should be done by gradually discontinuing the first preparation as the second is introduced and gradually increased. The optimum amount of lithium to be taken is based on clinical response and measured blood levels of lithium which guide the dose of lithium. Blood assays of lithium usually are obtained at 1 week after the start of lithium treatment, then monthly in the first 3 months. Subsequently, when the patient is considered stable, blood tests may be done every 6 months depending on age, general health, and response to treatment. Blood should be drawn at a consistent interval, at 10–14 (optimally, 12) hours after the last intake. If a dose is changed, 5–7 days should pass before measuring the blood level to allow tissue distribution to stabilize. Optimal doses of lithium are decided by a clinician, and depend on the patient’s age, general health, type of bipolar disorder, symptom-severity, and frequency of recurrences. Optimal daily trough blood concentrations of lithium for long-term treatment usually are between 0.50 and 0.60 and 0.80–1.00 mEq/L. Some patients may require higher concentrations, whereas for others, lower concentrations may suffice and better tolerated. For example, higher serum levels of lithium may be required for young patients with severe manic or psychotic symptoms (delusions, hallucinations) or patients with short intervals between episodes, whereas lower concentrations are often used and better tolerated by elderly patients.
Is lithium good for mania?
2017; Malhi et al. 2017; Perugi et al. 2019 ). As noted, lithium is used mostly as a long-term treatment to prevent mood-disorder recurrences. Its place in the treatment of acute mania has largely been dis placed in favor of some anticonvulsants and modern antipsychotic drugs, which act more rapidly and whose target doses can be reached within a few days. In particular, the most common current treatment for a manic episode is with modern antipsychotic agents for several months, with lithium introduced adjunctively or continued long-term by itself as a preventive treatment (Yatham et al. 2018 ).
What is lithium used for?
Lithium is used for acute-phase illness as well as for prevention of recurrent manic and depressive episodes. Manic episodes of bipolar disorders, maintenance treatment for manic depressive patients with a history of mania, bipolar depression, major depressive disorder, vascular headache, & neutropenia.
How long does lithium last?
The elimination half life of lithium is 18-24 hours.
How long does it take for lithium to be released?
Standard concentration peaks in 1-1.5 hours, slow release - 4-4.5 hours. Lithium does not bind to plasma proteins, is not metabolized and is excreted through the kidneys. The elimination half life of lithium is 18-24 hours. Obesity is associated with higher rates of lithium clearance.
What are the risk factors for lithium toxicity?
General Pearls about Lithium Toxicity: Risk factors for toxicity includes exceeding the recommended dosage, renal impairment, low-sodium diet, drug interactions, and dehydration. Elderly are more vulnerable. The higher the lithium level (concentration) the worse the s/s of toxicity will be.
Why not give lithium to pregnant women?
Do not administer to pregnant women in the 1st trimester because of the risk of birth defects. Most common CV defect is Ebstein's anomaly of the tricuspid valves. Lithium adverse effects. Greater than 80 of patients taking lithium experience side effects.
How many people have side effects from lithium?
Greater than 80 of patients taking lithium experience side effects.
How to remove residual gastric contents?
Acute ingestion - residual gastric contents should be removed by induction of emesis, gastric lavage, and polystyrene sulfonate (Kayexalate) or Golyletly.
Overview
Certain lithium compounds, also known as lithium salts, are used as psychiatric medication, primarily for bipolar disorder and for major depressive disorder that does not improve following the use of antidepressants. In these disorders, it sometimes reduces the risk of suicide. Lithium is taken orally.
Common side effects include increased urination, shakiness of the hands, and …
Medical uses
Lithium is approved by the United States Food and Drug Administration (FDA) for treatment of bipolar disorder, which is its primary use. It is sometimes used when other treatments are not effective in a number of other conditions, including major depression, schizophrenia, disorders of impulse control, and some psychiatric disorders in children. Because the FDA has not approved lithi…
Adverse effects
Sources for the following lists.
Very Common (> 10% incidence) adverse effects of lithium include
• Confusion
• Constipation (usually transient, but can persist in some)
• Decreased memory
Interactions
Lithium plasma concentrations are known to be increased with concurrent use of diuretics—especially loop diuretics (such as furosemide) and thiazides—and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. Lithium concentrations can also be increased with concurrent use of ACE inhibitors such as captopril, enalapril, and lisinopril.
Lithium is primarily cleared from the body through glomerular filtration, but some is then reabsorb…
Overdose
Lithium toxicity, which is also called lithium overdose and lithium poisoning, is the condition of having too much lithium in the blood. This condition also happens in persons that are taking lithium in which the lithium levels are affected by drug interactions in the body.
In acute toxicity, people have primarily gastrointestinal symptoms such as vomiting and diarrhea, which may result in volume depletion. During acute toxicity, lithium distributes later into the centr…
Mechanism of action
The specific biochemical mechanism of lithium action in stabilizing mood is unknown.
Upon ingestion, lithium becomes widely distributed in the central nervous system and interacts with a number of neurotransmitters and receptors, decreasing norepinephrine release and increasing serotonin synthesis.
Unlike many other psychoactive drugs, Li typically produces no obvious psychotropic effects (su…
History
Lithium was first used in the 19th century as a treatment for gout after scientists discovered that, at least in the laboratory, lithium could dissolve uric acid crystals isolated from the kidneys. The levels of lithium needed to dissolve urate in the body, however, were toxic. Because of prevalent theories linking excess uric acid to a range of disorders, including depressive and manic disorders, Carl Lange in Denmark and William Alexander Hammond in New York City used lithium t…
Salts and product names
Many different lithium salts can be used as medication, including lithium carbonate, lithium acetate, lithium sulfate, lithium citrate, lithium orotate, and lithium gluconate.
Lithium carbonate (Li 2CO 3), sold under several trade names, is the most commonly prescribed, while lithium citrate (Li 3C 6H 5O 7) is also used in conventional pharmacological treatments. Lithium orotate (C 5H 3LiN 2O 4), has been presented as an alternative. Lithium bromide and lithiu…