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Lithium

Overview
Lithium Carbonate is a naturally occurring, mood-stabilizing, anti-manic compound that is the most widespread treatment for bipolar disorder. It has been used since the 1870s to treat a variety of illnesses, including depression, gout, neutropenia, and cluster headache prophylaxis. It was banned by the U.S. Food and Drug Administration in 1949 because of its toxic side effects, but the ban was lifted in 1970.
Common brand names include Carbolith, Cibalith-S, Duralith, Eskalith, Eskalith CR, Lithane, Lithizine, Lithobid, Lithonate, and Lithotabs.

Side Effects
The common side effects of lithium include:

  • Mild thirst
  • Mild nausea
  • Itchiness
  • Loss of appetite
  • Thinning of the hair
  • Muscle weakness
  • Weight gain
  • Acne
  • Poor concentration

Some of the more serious side effects include:

  • Lightheadedness
  • Fainting
  • Hallucinations or seizures
  • Fever
  • Hand tremors
  • Extreme thirst
  • More or less frequent urination
  • Pain or discoloration in the fingers or toes
  • Eye pain or vision problems
  • Impaired memory
  • Psychosis
  • Kidney failure
  • Decreased thyroid function

Alternative Medications
While lithium is the most commonly used and widely accepted treatment regimen, there are numerous alternatives available. They mainly fall under two different categories of medications: antiepileptics (or anticonvulsants) and antipsychotics. Before deciding whether to change medications it is very important to talk about side effects with a health care specialist.

Anti-Psychotic Alternatives

  • Olanzapine: This drug was found to be as effective in the treatment of bipolar disorder in a 2005 study reported in the American Journal of Psychiatry. The side effects include weight gain, constipation, sleepiness, and dry mouth.
  • Quetiapine: The side effects of this drug are weight gain, constipation, sleepiness, and dry mouth.
  • Aripiprazole: The side effects of this include restlessness, tremors, anxiety, weight gain, and dry mouth.
  • Asenapine: This drug’s side effects include sedation, weight gain, dizziness, and insomnia.

Anti-Epileptic Alternatives

  • Lamotigrine: This drug’s side effects include gastrointestinal upset, insomnia, and rash. It also has a rare, but potentially fatal side effect of Steven-Johnson Syndrome.
  • Divalproex: This drug is less effective in the treatment of bipolar disorder, and the side effects include weight gain, sleepiness, gastrointestinal upset, hair loss, and tremors.
  • Oxcarbazepine and Carbemazepine: These drugs are structurally similar, while oxcarbazepine has less intense side effects, including gastrointestinal upset, dizziness, and sleepiness.

Overdose
Therapeutic levels of lithium are only slightly lower than levels that are considered to be toxic. It is ideal for individuals who are using lithium carbonate to have regular blood testing done.

Symptoms of Overdose

    • Loss of appetite
    • Fatigue
    • Confusion
    • Slurred speech
    • Coma
    • Sleeplessness
    • Dizziness/Vertigo
    • Tremors
    • Twitching
    • Ataxia
    • Hyperactive deep tendon reflexes
    • Cardiac arrhythmia
    • Drowsiness
    • Unmasking of Brugada Syndrome
    • Blackout spells
    • Hypotension
    • Nausea or vomiting
    • Diarrhea
    • Poor coordination
    • Muscle weakness
    • Blurred vision
    • Ringing in the ears

Lithium poisoning is a potentially life threatening event and should be attended to immediately by a healthcare professional.

WORKS CITED:

    1. “Bipolar Disorder Health Center.” Lithium for Bipolar Disorder. WebMD. n.a. Web. 17 January 2013.
    2. “Lithium Side Effects.” Drugs.com. n.a. Web. 17 January 2013.
    3. “Lithium Toxicity.” Medscape. 18 November 2010. Web. 17 January 2013.