Lithin SR

Indications

Used for the treatment and prevention of mania, bipolar disorder, and recurrent depression. Consult a registered healthcare professional before use.

Pharmacology

Despite over 50 years of use in managing bipolar disorder, the precise mechanism of action of lithium remains unclear. Its therapeutic effects may arise from inhibiting enzymes like glycogen synthase kinase 3 and inositol phosphatases, as well as modulating glutamate receptors. Lithium carbonate influences the intraneuronal metabolism of catecholamines and sodium transport in neurons and muscle cells.

Dosage & Administration

Adults and Children Over 12: Initial dosage is 1 to 1.5 grams daily; for prophylaxis, start with 300-400 mg daily. It should be taken with food. Consult a registered healthcare professional before use.

Interaction

Lithium may have reduced serum levels when taken with carbonic anhydrase inhibitors, chlorpromazine, sodium-containing preparations, theophylline, and urea. Its effects may be enhanced by iodine salts and neuromuscular-blocking agents, while pressor responses to sympathomimetics may be reduced.

Contraindications

Contraindicated in patients with renal insufficiency, cardiovascular insufficiency, Addison’s disease, and untreated hypothyroidism.

Side Effects

Common side effects include fatigue, appetite loss, nausea, vomiting, diarrhea, hand tremors, memory issues, increased thirst, and more frequent urination both day and night.

Pregnancy & Lactation

Pregnancy Category D: There is an increased risk of cardiovascular abnormalities in infants born to mothers who used lithium during the first trimester. Its use should be avoided unless absolutely necessary. Breastfeeding is not recommended unless benefits outweigh the risks.

Precautions & Warnings

Prolonged sweating or diarrhea can decrease lithium tolerance. In such cases, fluid and salt supplementation is necessary, and lithium intake should be reduced or halted until the condition stabilizes.

Use in Special Populations

Renal Impairment: For patients with CrCl 10-50, reduce the dosage to 50-75% of the normal dose.

Overdose Effects

If lithium accumulates, discontinue use and monitor serum levels every six hours. Do not use diuretics. Initiate osmotic diuresis or urine alkalinization as needed. For serum lithium levels above 4.0 mmol/L or worsening patient conditions, consider peritoneal or hemodialysis until serum levels normalize.

Therapeutic Class

Anti-manic agents.

Storage Conditions

Store at 25°C.