Lithium (side Effects)

Question 1

Side effects of lithium

Answer 1

Side-effects of lithium include:-

Drowsiness
Dry mouth
Polyuria
Polydipsia
Nausea
Weight gain
Fine tremor
Metallic taste
Diarrhoea
Muscle weakness

Side-effects are dose (plasma level) related. Propranolol can be helpful for fine tremor. Lithium is also known to exacerbate certain skin conditions including psoriasis and acne.

Long-term use is associated with the following:-

Hypothyroidism
Irreversible nephrogenic diabetes insipidus
Reduced GFR (chronic kidney disease)
Hyperparathyroidism

Question 2

Hypercalcemia

Answer 2

Hyperparathyroidism refers to over action of parathyroid hormone which causes raised calcium. Symptoms of hypercalcemia include:-

Groans (constipation)
Stones (kidney stones)
Bones (bone pain)
Psychic moans (depression, lethargy, confusion)

Question 3

Dopamine agonist

Answer 3

Dopamine receptor agonists have a direct action on dopamine receptors. They are often used in the treatment of Parkinson’s disease. Examples include:-

apomorphine
ropinirole

These drugs are associated with psychiatric side effects (BNF 2012), particularly impulse control disorders such as:-

pathological gambling
binge eating
hypersexuality