Lithium
is classified das a mood stabilizer. It is a simple element, found
in nature in some mineral waters, and is present in small amounts
in the human body.
Uses
Lithium
is used primarily in the treatment of acute mania and in the long
term control or prophylaxis of Manic Depressive Illness (Bipolar
Disorder).
Though
not approved for this indications, lithium has also been found to
augment the effects of antidepressants and obsessive compulsive
disorder, and is useful in the treatment of cluster headaches, as
well as chronic aggression or impulsivity.
How
does the doctor decide what dose (how many milligrams) to
prescribe?
The
dose of lithium is different for every patient and is based on how
much lithium is in the blood on a regular basis during the first
few months. The lithium level that is usually found to be
effective for most patients is between 0.6 and 1.2 mmol/l (mq/l)
You
may initially take your medication several times a day (2 or 3);
after several weeks, the doctor may decide to prescribe the drug
once daily. It is
important to drink 8-12 cups of fluid daily when on lithium (e.g.
water, juice, milk, broth, etc)
On
the morning of your Lithium blood test, take the morning dose of
lithium after the test to avoid inaccurate results.
How
quickly will the drug start working?
Control
of manic symptoms may require up to 14 days of treatment. Because
lithium takes time to work, do not
decrease or increase the dose or stop the medication
without discussing this with your doctor.
Improvement
in symptoms of
depression, obsessive compulsive
disorder, cluster headaches, as well as
aggression/impulsivity also occur gradually.
How
long should you take the medication?
Following
the first episode of mania it is recommended that lithium be
continued for a minimum of one year; this decreases the chance of
being ill again. The doctor may then decrease the drug slowly and
monitor for any symptoms ; if none occur the drug can be gradually
stopped.
For
individuals who have had several episodes of mania or depression,
lithium should be continued indefinitely.
Long
term treatment is
generally recommended for recurring depression,
obsessive-compulsive disorder, cluster headaches or aggression/
impulsivity.
Side
effects
Side
effects occur to some degree, with all medication. They are
usually not serious and do not occur in all individuals . They may
sometimes occur before beneficial effects of the medication are
noticed. If a side effect continues, speak to your doctor about
appropriate treatment.
Common
side effects that should be reported to your doctor at the next
appointment include:
-
Lethargy,
difficulty concentrating-this problem usually goes away with
me. Use of other drugs that make you drowsy will worsen the
problem. Avoid driving a car or operating machinery if
drowsiness persists.
-
Nausea
or heartburn- If this happens; take the medication with food.
If vomiting of diarrhea occur and persist for more than 24
hours, call your doctor.
-
Muscle
tremor, weakness, shakiness, stiffness-Speak to your doctor as
this may require an adjustment in your dosage.
-
Changes
in sex drive or sexual performance-Discuss this with your
doctor.
-
Weight
changes-Monitor your food intake, avoid foods with high fat
content (e.g. cakes pastry)
-
Increased
thirst and increase in frequency of urination-discuss this
with your doctor.
-
Skin
changes, e.g. dry skin, acne, rashes.
Side
effects you should report IMMEDIATELY , as they may indicate the
amount of lithium in
the body is than it should be, include:
- Loss
of Balance
- Slurred
speech
- Visual
disturbances (e.g. double vision)
- Nausea,
vomiting, stomach ache
- Watery
stools, diarrhea (more than twice a day)
- Abnormal
general weakness or drowsiness
- Marked
trembling (e.g. shaking that interferes with holding a cup),
muscle twitches, jaw shaking
If
these occur call your doctor right away. IF THESE OCCUR CALL YOUR
DOCTOR RIGHT AWAY. If you cannot reach your doctor ,stop taking
the lithium until you get in touch with him. Drink plenty of
fluids and snack on salty food (e.g. chips, crackers) >IF
symptoms continue to get worse , or if they do not clear within 12
hours, go to the emergency department of the nearest hospital. A
clinical checkup and a blood test will show the cause of the
problem.
Rare
side effects that you should report to your doctor immediately
include:
- Soreness
of the mouth, gums, or throat
- Skin
rash or itching , swelling of the face.
- Nausea,
vomiting, loss of appetite,
lethargy weakness, fever or flu like symptoms
- Swelling
of the neck (goiter)
- Abnormally
frequent urination and increased thirst (i.e. having to get up
in the night several times to pass urine)
Let
your doctor know as soon as possible if you miss your period or
suspect you may be pregnant.
What
should you do if you forget to take a dose of your medication?
If
you take your dose of lithium in the morning and you forget to
take it for more than 6 hours, skip the missed dose and continue
with your schedule the next day. DO NOT DOUBLE THE DOSE. If you
take the drug several times a day, take the missed dose when you
remember, then continue with your regular schedule.
Interactions
with other medication
Because
lithium can change the effect of other medication, or may be
affected by other medication, always check with your doctor
pharmacist before
taking other drugs, including
over- the counter -medication such as cols remedies. Always
inform your doctor or dentist that you see that your are taking
lithium.
Precautions
-
Do
not increase or decrease your without consulting your
doctor.
-
This
drug may impair the mental and physical abilities and
reaction time required for driving a car or operating
machinery. Avoid these activities if you feel drowsy or
slowed down.
-
Do
not stop your drug suddenly as this may result in withdrawal
symptoms such as anxiety, irritability and emotional
labiality.
-
Report
any changes in mood or behavior
to your physician.
-
It
is important to drink 8-12 cups of fluid daily (e.g. water,
juice, milk, broth, etc)
-
do
not change your salt intake during your treatment, without
first speaking to your doctor. (e.g. avoid no salt or low
salt diets)
-
If
you have the
flu, especially if vomiting or diarrhea occur, check with
your doctor regarding your lithium dose.
-
Use
extra care in hot weather and during activities tat cause
you to sweat heavily (e.g. hot baths, saunas exercising).
The loss of too much water and salt from your body may lead
to changes in the level of lithium in your body.
-
Tablets
or capsules of lithium
should be swallowed whole; do not crush them;
-
Store
your medication in a clean , dry area at room temperature.
Keep all medication out of reach of children.
If
you have any questions regarding this medication, do not hesitate
to call your doctor, pharmacist, or nurse.
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