Side effects lithium

Other late-appearing lithium side effects include benign reversible leukocytosis, acne, alopecia, exacerbation of psoriasis, pruritic dermatitis, mac-ulopapular rash, folliculitis, and weight gain. 

Divalproex (Depakote) was found to reduce temper outbursts and emotional lability in 10 adolescents with conduct disorder (Donovan et al., 1997). Studies of carbamazepine have yielded conflicting results. Cueva et al. (1996) did not find carbamazepine to be more effective than placebo in treating children hospitalized for conduct disorder in a double-blind, placebo-controlled study. As in the case of lithium, side effects (rashes, leukopenia, nausea, drowsiness) can be an issue with carbamazepine, offsetting its use. 

Therapeutic Potential of Inositol Treatment in Depression, Panic, Dementia, and Lithium Side Effects... 

Henry C. Lithium side-effects and predictors of hypothyroidism in patients with bipolar disorder sex differences. J Psychiatry Neurosci 2002 27(2) 104-7. 

Vacaflor L. (1975) Lithium side effects and toxicity the clinical picture. In F. N. Johnson (Ed.) Lithium Research and Therapy, Academic PresS London pp. 211-226. 

Lithium. In the lithium carbonate treatment of certain psychotic states, a low incidence (3.6%) of hypothyroidism and goiter production have been observed as side effects (6,36) (see Psychopharmacologicalagents). It has been proposed that the mechanism of this action is the inhibition of adenyl cyclase. Lithium salts have not found general acceptance in the treatment of hyperthyroidism (see Lithiumand lithium compounds). 

Following initial assessment, including evaluation of potential suicidality, support systems, and need for inpatient versus outpatient treatment, MW was hospitalized briefly, then followed in the community on medication along with psychotherapy. She has abstained from illicit substances and has returned to her job. She has responded well to treatment with sustained-release lithium carbonate 900 mg once daily at bedtime with a snack. Steady-state 12-hour serum lithium concentrations have stabilized at 0.9 mEq/L (0.9 mmol/L). She now returns to clinic for routine followup. She has tolerated the lithium except for a mild tremor and a gain of 7 pounds (3.2 kg). She is willing to accept these side effects for now, but asks about how long she must take medication since she is now feeling well. 

Lithium presents yet another model of ethnic variation in side effects and response. It is well established that African Americans show a higher red blood cell (RBC) to plasma ratio of lithium concentration when compared to Asians and... 

The clinical significance of this ethnic difference for psychiatry was found later. A study examining lithium tolerability found more side effects in African American patients with high RBC/plasma ratio even when the lithium levels were in the therapeutic range (Strickland etal., 1995). It is not known whether African Americans require lower doses and will respond with lower plasma levels. We do know that African Americans with mood disorders are less likely to be prescribed lithium either as primary treatment or adjunctive therapy (Valenstein etal., 2006 Kilbourne 8c Pincus, 2006). It is unknown as to whether the lack of tolerability at usual therapeutic doses is a factor. 

Lee, S. (1993). Side effect of chronic lithium therapy in Hong Kong Chinese an ethnopsychiatric perspective. Cult. Med. Psychiatry, 17, 301-20. 

Lithium toxicity can generate side effects even at therapeutic doses. Lithium... 

Ari pi prazole, olanzapine, quetiapine, risperidone, and ziprasidone are effective as monotherapy or as add-on therapy to lithium or valproate for acute mania. Prophylactic use of antipsychotics can be needed for some patients with recurrent mania or mixed states, but the risks versus benefits must be weighed in view of long-term side effects (e.g., obesity, type 2 diabetes, hyperlipidemia, hyperprolactinemia, cardiac disease, and tardive dyskinesia). 

Augmenting antidepressants with lithium has repeatedly been shown to be effective. But lithium is a difficult medication to take. It is very dangerous in overdose and can quickly reach toxic levels due to fluid loss from diarrhea, profuse sweating, or high fevers. Even at treatment levels, lithium can produce unpleasant side effects such as dizziness, frequent urination, and tremors. Despite all its problems, lithium... 

Carbamazepine is also most beneficial for patients with mixed episodes and rapid cycling. However, many patients find the side effects of carbamazepine more troublesome than those of valproate, and becanse carbamazepine has a penchant for nntoward drug-drug interactions, we reserve the use of carbamazepine for those patients who are unable to tolerate valproate, lithium, and the atypical antipsychotic... 

Increasing the dose of the current mood stabilizer deserves consideration when the medication level is at the lower end of the therapeutic range. This has the advantage of keeping the treatment simpler and less costly. However, as the dose is increased, the potential for intolerable side effects or toxicity (especially with lithium) becomes greater. 

Lithium salts, generally in the form of the carbonate or bicarbonate, are rapidly absorbed from the gastrointestinal tract and reach a peak plasma concentration after 2- hours. Extreme fluctuations in blood lithium levels, which are associated with side effects such as nausea, diarrhoea and abdominal cramp, are reduced by using sustained release preparations. Lithium is not protein bound and therefore is widely distributed throughout the body water, which accounts for the adverse effects it has on most organ systems should it reach toxic levels. To avoid toxicity, and ensure optimal... 

As lithium is an alkaline earth metal which readily exchanges with sodium and potassium, it is actively transported across cell membranes. The penetration of kidney cells is particularly rapid, while that of bone, liver and brain tissue is much slower. The plasma CSE ratio in man has been calculated to be between 2 1 and 3 1, which is similar to that found for the plasma red blood cell (RBC) ratio. This suggests that the plasma RBC ratio might be a useful index of the brain concentration and may be predictive of the onset of side effects, as these appear to correlate well with the intracellular concentration of the drug. 

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