Side effects of lithium

Most of the lithium is eliminated in the urine, the first phase of the elimination being 6-8 hours after administration, followed by a slower phase which may last for 2 weeks. Sodium-depleting diuretics such as frusemide, ethacrynic acid and the thiazides increase lithium retention and therefore toxicity, while osmotic diuretics as exemplified by mannitol and urea enhance lithium excretion. The principal side effects of lithium are summarized in Table 8.1. 

Weight gain is a frequent side effect of lithium treatment. Dermatological Effects... 

Colgate R. The ranking of therapeutic and toxic side effects of lithium carbonate. Psychiatr Bull 1992 16 473-475. 

IZ Lithium carbonate is often administered only in the treatment of manta or depression or both. From what you have learned of ihe diagnnr relationships in Ihe periodic chart, predict one possible unpleasant side effect of lithium therapy. 

Long-term side effects of lithium treatment include weight gain. The treatment is associated with development of hypothyroidism in about 10-15% of cases. There is an association with kidney disease. Birch has expressed the general view that Li may interact with magnesium-dependent processes, and theoretical chemistry supports this view. Despite the widespread clinical significance of Li, there is presently no consensus on its mode of action. One postulate for the mechanism is termed hyperpolarization . Li affects the conductivity in cell transport channels. Other explanations include modulation of neurotransmitter concentrations and inhibition of Na+/K+/Mg2+/ Ca2+ ATPases. 

Arts BMG, Honig A, Riedel WJ, Ponds RWHM. Cognitive side effects of lithium a meta-analysis and proposal for screening. Tijdschr Psychiatr 1998 40 460-8. 

Niethammer R, Keller A, Weisbrod M. Delirantes Syndrom als Lithium-nebenwirkung bei normalen Lithiumspiegeln. [Delirium syndrome as a side-effect of lithium in normal lithium levels.] Psychiatr Prax 2000 27(6) 296-7. 

Possible side effects of lithium therapy are stomach ache, nausea, vomiting, diarrhea, hand tremors, thirst, fatigue, and muscle weakness. Some patients report weight gain while on lithium and a thyroid condition may develop, but can be easily treated with thyroid replacement hormones. 

It has been long recognized that prolonged lithium therapy can cause hypothyroidism. In fact, determination of serum thyroid-stimulating hormone once a year is recommended in all subjects on prolonged lithium therapy [32, 33]. Lithium perturbs receptor-mediated signaling events such as cyclic adenosine monophosphate and inositol phosphate accumulation [34]. These effects likely explain many hormonal side effects of lithium. 

Vestergaard, R, A. Amdisen, and M. Schow. 1980. Clinically significant side effects of lithium treatment. Acta Psychiatrica Scandinavica 62 193-200. 

Garrod described some of the side effects of lithium in 1881 . . ... 

Pharmacologically, lithium as a drug does not lose its efficacy, and does not induce addiction or dependence. Consequently, lithium retains its full effect even if it has been administered for long periods (even years). Moreover, both the effects and side effects of lithium are completely reversible indeed, a mechanical switch-on and -off function of lithium s biochemical mechanism has been discussed, though the details of this remain unknown (Schafer 1998,... 

Common side effects of lithium include nausea, loss of appetite, and mild diarrhea, which usually taper off within first few weeks. Dizziness and hand tremors also have been reported. Increased production of urine and excessive thirst are two common side effects that usually are not serious problems, but patients with kidney disease should not be given lithium. Taking the day s dosage of lithium at bedtime also seems to help with the problem of increased urination. Other side effects of lithium include weight gain, hypothyroidism, increased white blood cell count, skin rashes, and birth defects. 

A number of other side effects of lithium have been noted after prolonged therapy, including exacerbation of dermatological disorders, mild leukocytosis, hypothyroidism, and hypoparathyroidism. 

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