Lithium

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Mechanism of Action

Use

  • Bipolar Disorder
  • Depression Augmentation

Adverse Reactions

Cardiovascular: Abnormal T waves on ECG, bradycardia, cardiac arrhythmia, chest tightness, circulatory shock, cold extremities, edema, hypotension, myxedema, sinus node dysfunction, startled response, syncope

Central nervous system: Ataxia, blackout spells, cogwheel rigidity, coma, confusion, dizziness, drowsiness, dystonia, EEG pattern changes, extrapyramidal reaction, fatigue, hallucination, headache, hyperactive deep tendon reflex, hypertonia, involuntary choreoathetoid movements, lethargy, local anesthesia, memory impairment, loss of consciousness, metallic taste, myasthenia gravis (rare), pseudotumor cerebri, psychomotor retardation, reduced intellectual ability, restlessness, salty taste, sedation, seizure, slowed intellectual functioning, slurred speech, stupor, tics, vertigo, worsening of organic brain syndromes

Dermatologic: Acne vulgaris, alopecia, blue-gray skin pigmentation, dermal ulcer, dry or thinning of hair, exacerbation of psoriasis, folliculitis, pruritus, psoriasis, skin rash, xerosis

Endocrine & metabolic: Hypothyroidism (females 14%; males 5% [Johnston 1999]; children and adolescents: <1% [Findling 2015]), albuminuria, dehydration, diabetes insipidus, euthyroid goiter, glycosuria, hypercalcemia (secondary to hyperparathyroidism [McKnight 2012]), hyperglycemia, hyperparathyroidism, hyperthyroidism, increased radioactive iodine uptake, increased thirst, polydipsia, weight gain, weight loss

Gastrointestinal: Abdominal pain, anorexia, dental caries, diarrhea, dysgeusia, dyspepsia, excessive salivation, flatulence, gastritis, nausea, vomiting, sialadenitis, sialorrhea, swelling of lips, xerostomia

Genitourinary: Impotence, incontinence, oliguria

Hematologic & oncologic: Leukocytosis

Hypersensitivity: Angioedema

Neuromuscular & skeletal: Joint swelling, muscle hyperirritability, neuromuscular excitability, polyarthralgia, tremor

Ophthalmic: Blurred vision, exophthalmos, nystagmus, transient scotoma

Otic: Tinnitus

Renal: Decreased creatinine clearance, polyuria

Miscellaneous: Fever

Interactions

Monitoring

  • Monitor CBC for leukocytosis
  • Monitor Thyroid function
  • Monitor BMP for kidney function

Sources