Lithium Pharmacology


About Lithium
Antipsychotic, Lithium compounds , Anti manic, Mood stabilizer.
Mechanism of Action of Lithium
The exact mechanism of action of Lithium is not known. Proposed mechanism is
1. Lithium inhibits the formation of Inositol from Inositol phosphate. Inositol is the precursor for the synthesis of Phosphatidyl Inositol biphosphate (PIP2) which is used for the synthesis of Phospholipase C. Inhibition of Phospholipase C synthesis results in decrease brain Inositol triphosphate (IP3) and Diacyl glycerol (DAG) concentration and reduces the sensitivity of some neurons to the action of various neurotransmitters.
2. Lithium also inhibits second messenger system involving Adenyl cyclase. It alters sodium transport in nerve and muscle cells and increases the interneuronal metabolism of catecholamine and serotonin.
3. Modification of inhibitory neurotransmitter GABA concentrations in the brain
4. Decrease the function of brain protein kinase and alter the release of neurotransmitters and hormones.
Pharmacokinets of Lithium
Absorption: Lithium is rapidly absorbed after oral administration. Distribution: It is very widely distributed in the body. Metabolism: Lithium does not undergo metabolism. Excretion: The drug is excreted as such in urine.
Onset of Action for Lithium
3 weeks
Duration of Action for Lithium
Half Life of Lithium
24 hours
Side Effects of Lithium
4.Abdominal discomfort
7.Reversible ECG changes
13.Slurred speech
14.Blurred vision
Contra-indications of Lithium
1.Cardiovascular diseases(Arrhythmia, Bradycardia, Reversible ECG changes, Hypotension)
2.Renal impairment
Special Precautions while taking Lithium
1.Thyroid disease
2.Seizure disorder
3.Severe dehydration
Pregnancy Related Information
Old Age Related Information
Used with caution.
Breast Feeding Related Information
Children Related Information
use with caution
CHILDREN below12 years: contraindicated
NEONATES: contraindicated
Indications for Lithium
2.Prevention of recurrent attack of bipolar manic depressive illness
3.Major depression
4.Schizophrenic disorder
5.Chemotherapy induced neutropenia
Interactions for Lithium
Acetazolamide: Increased renal excretion of lithium.
Carbamazepine: Increased neurotoxic effects of lithium despite therapeutic serum levels.
Fluoxetine: Increased serum levels of lithium.
Haloperidol: Increased neurotoxic effects of lithium despite therapeutic serum levels.
Loop & thiazide diuretics: Increased lithium serum levels.
Methyldopa: Increased neurotoxic effects of lithium.
NSAIDs: Decreased renal clearance of lithium.
Theophyllines: Increased renal excretion of lithium.
Urinary alkalisers: Enhanced renal lithium clearance.
Iodide salts: Synergistic action producing hypothyroidism.
Neuromuscular blocking agents: Increased neuromuscular blockade resulting in severe respiratory depression.
Sympathomimetics: Pressor sensitivity of sympathomimetics may be decreased.
TCAs: Pharmacological effects of TCAs may be increased.
Typical Dosage for Lithium
Adult: 300 mg 3 - 4 times daily.
Mania, Prevention of recurrent attack of bipolar manic depressive illness:
Acute episodes: 1.8 g / day in 3 divided doses serum concentration of Lithium should be maintained at 0.8 - 1.2 mEq / L. Dose is determined on the basis of clinical response and serum levels.
Serum level should be checked twice weekly until clinical response and serum levels are stabilized.
Maintenance dose: 900 - 1200 mg / day in 3 - 4 divided doses and serum level 0.5 - 1 mEq / L
Schedule of Lithium
Storage Requirements for Lithium
Store in a cool dry area in a tightly closed container. Protect from heat and light.
Effects of Missed Dosage of Lithium
Take the missed dose as soon as noticed. If it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Lithium
Give supportive measures and symptomatic treatment. Gastric lavage can be done to remove the drug from the body. Correct fluid and electrolyte balance. Haemodialysis is an effective and rapid means of method to remove the drug from the severely toxic patients.

Home Delivery for Lithium in Your City

Medicine India is just a publishing medium for medicine related information and does not provide services or sales of medicines including lithium.

However, we do publish a comprehensive directory of Pharmacies, Chemists and Druggists in cities all over India. You can use this directory to find the medicine stores in your city (or area) that provide home delivery services for lithium and other medicines and health products. Home delivery services for lithium may be free or they may cost you depending on the pharmacy and the minimum order requirements. It would be best to get this clarified while placing the order.

Please be aware that you should take lithium only if a doctor has recommended or prescribed it. Some or all pharmacies who provide a home delivery service for medicines might insist on a prescription for lithium before they complete the sale. You can get this information while placing the order for lithium with the pharmacy.

Lithium is a generic medicine name and there are several brands available for it. Some of the brands for lithium might be better known than lithium itself. If the pharmacy that's willing to deliver medicines to your home doesn't have lithium in stock, you can ask for one of the branded alternatives for lithium.