Select therapeutic use:
Indications for LITHOBID:
Mania in bipolar disorder.
Swallow whole. Acute mania: 1800mg/day in 2–3 divided doses. Usual maintenance: 900–1200mg daily in 2–3 divided doses.
Increased risk of lithium toxicity in renal or cardiovascular disease, severely debilitated or dehydrated, sodium depletion, concomitant diuretics, ACE inhibitors, or ARBs: not recommended (if necessary, use low doses, monitor serum lithium levels daily). Brugada syndrome: avoid. Seizure disorders. Organic brain syndrome or other CNS impairment: monitor for neurologic toxicity. Maintain adequate fluid and salt intake esp. with fever, sweating, diarrhea, or infection. Monitor serum lithium levels frequently (toxic and therapeutic levels are close); draw blood for serum tests 8–12 hrs after previous dose. Monitor thyroid, renal function. Discontinue if diarrhea, vomiting, tremor, ataxia, drowsiness or weakness occur. Elderly. Pregnancy (Cat.D), nursing mothers: not recommended.
Lithium toxicity potentiated by diuretics, ACE inhibitors, ARBs, carbamazepine, indomethacin, piroxicam (possibly other NSAIDs, including COX-2 inhibitors), metronidazole, calcium channel blockers; monitor. Discontinue if signs of neurologic toxicity occur with neuroleptics (eg, haloperidol). Xanthines, acetazolamide, urea, alkalinizing agents may reduce serum lithium levels. Fluoxetine has variable effects on serum lithium levels. Prolongs effects of neuromuscular blockers. Hypothyroidism with chronic iodide administration. Serotonin syndrome with SSRIs.
Polyuria, polydipsia, drowsiness, tremor, hypothyroidism, extrapyramidal symptoms, nausea, renal toxicity, seizures, arrhythmias, hypotension, lethargy, metallic taste, dry mouth, blurred vision, pseudotumor cerebri (discontinue if occurs).