Lithium

Question 1

How it works

Answer 1

Mood stabiliser.

Exact mechanism unknown. Thought to enter the cells and interfere with the release of some brain chemicals and messenger systems.

Question 2

Treatment course

Answer 2

Once or twice daily depending on brand

Question 3

How to take

Answer 3

Tablet, capsule or syrup

Question 4

Length of treatment

Answer 4

Lifelong usually (if it works)

Regular reviews by psychiatrist

Question 5

Effects- time before

Answer 5

1-2 weeks

Question 6

Tests

Answer 6

Before starting - FBC, U&Es, TFTs, beta HCG, ECG

Check lithium levels after 5 days then every week until stable for 4 weeks, then every 3 months.

Check TFTs, U&Es, Ca2+ every 6 months

Question 7

Side effects

Answer 7

GI (abdo pain, nausea)
Metallic taste
Water symptoms e.g. Thirst, polyuria, oedema

Toxicity symptoms - anorexia, diarrhoea, vomiting, dizziness, ataxia, muscle twitching, tremor, drowsiness, restlessness

Question 8

Complications and contraindications

Answer 8

Renal toxicity, nephrogenic diabetes insipidus, hypothyroidism

1st trimester of pregnancy, breast feeding, cardiac disease, significant renal impairment, Addison’s disease….

Question 9

Supplementary advice

Answer 9

www.bipolar.org.uk