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Lithium is a naturally occurring element that is classified as an anti-manic drug. It is available in the United States under the brand names Eskalith, Lithonate, Lithane, Lithotabs, and Lithobid. It is also sold under its generic name.
Lithium is commonly used to treat mania and bipolar depression (manic-depression or bipolar disorder). Less commonly, lithium is used to treat certain mood disorders, such as schizoaffective disorderand aggressive behavior and emotional instability in adults and children. Rarely is lithium taken to treat depression in the absence of mania. When this is the case, it is usually taken in addition to other antidepressant medications.
Lithium salts have been used in medical practice for about 150 years. Lithium salts were first used to treat gout. It was noted in the 1880s that lithium was somewhat effective in the treatment of depression, and in the 1950s lithium was seen to improve the symptoms of bipolar disease. The way lithium works in the body is unclear, but its therapeutic benefits are probably related to its effects on other electrolytes such as sodium, potassium, magnesium, and calcium. Lithium is taken either as lithium carbonate tablets or capsules or as lithium citrate syrup.
The therapeutic effects of lithium may appear slowly. Maximum benefit is often not evident for at least two weeks after starting the drug. People taking lithium should be aware of this and continue taking the drug as directed even if they do not see immediate changes in mood.
Lithium is available in 300-mg tablets and capsules, 300-mg and 450-mg sustained-release tablets, and a syrup containing approximately 300 mg per teaspoonful.
Depending on the patient's medical needs, age, weight, and kidney function, doses of lithium can range from 600 to 2,400 mg per day, although most patients will be stabilized on 600 to 1,200 mg per day. Patients who require large amounts of lithium often benefit from the addition of another anti-manic drug, which may allow the dose of lithium to be lowered.
Generally, lithium is taken two or three times daily. However, the entire dose may be taken at once if the physician believes that a single daily-dose program will increase patient compliance. The single dose schedule is especially helpful for people who are forgetful and may skip doses on a multiple dose schedule. Additionally, evidence indicates that once-daily doses are associated with fewer side effects.
More than with any other drug used in the treatment of mental disorders, it is essential to maintain lithium blood levels within a certain narrow range to derive the maximum therapeutic benefit while minimizing serious negative side effects. It is important that people taking lithium have their blood levels of lithium measured at regular intervals.
Author Info: Jack H. Raber Pharm.D., The Gale Group Inc., Gale, Detroit, Gale Encyclopedia of Mental Disorders, 2003
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