Lithium
- Atc Codes:N05AN#D11AX04
- CAS Codes:6080-58-6#919-16-4#554-13-2#16090-09-8
- PHARMGKB ID:6080-58-6#919-16-4#554-13-2#16090-09-8
Table of contents
- Brand Names
- Drug Combinations
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Unlabeled Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Caution and personalized dose adjustment in patients with the following genotypes
- Other genes that may be involved
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Lithiumchlorid, Neurolepsin, Quilonorm; Belgium: Camcolit, Maniprex, Priadel; Bulgaria: Lithium; Cyprus: Priadel; Czech Republic: Lithium; Denmark: Litarex, Lithiumkarbonat; Finland: Lito; France: Granions de Lithium, Microsol, Teralithe; Germany: Hypnorex, Lithiofor, Lithium, Quilonorm, Quilonum; Greece: Milithin; Hungary: Liticarb; Ireland: Camcolit, Lithium, Priadel; Italy: Carbolithium; Luxembourg: Camcolit, Priadel, Quilonum; Netherlands: Camcolit, Lithium, VSM; Poland: Lithium; Portugal: Priadel; Romania: Lithium; Slovakia: Lithium; Slovenia: Litijev; Spain: Citinoides, Litio, Plenur; Sweden: Lithionit, Litiumklorid; UK: Camcolit, Li-Liquid, Liskonum, Priadel.
North America
Canada: Carbolith, Lithane, Lithium; USA: Eskalith, Lithium, Lithobid.
Latin America
Argentina: Ceglution, Eskalit, Karlit, Lithiun; Brazil: Carbolim, Carbolitium, Neurolithium; Mexico: Carbolit, Litheum.
Asia
Japan: Limas, Lithium, Litiomal.
Drug combinations
Lithium, Aspirin, and Quinine
Chemistry
Lithium Citrate: C~6~H~5~Li~3~O~7~ 4H~2~O. Mw: 281.98. (1) 1,2,3-Propanetricarboxylic acid, 2-hydroxy-trilithium salt tetrahydrate; (2) Trilithium citrate tetrahydrate. CAS-6080-58-6; CAS-919-16-4 (anhydrous).
Lithium Carbonate: Li~2~CO~3~. Mw: 73.89. Carbonic acid, dilithium salt. CAS-554-13-2 (1968).
Lithium succinate: C~4~H~6~LiO4^+^. Mw: 125.03. CAS-16090-09-8.
Pharmacologic Category
Antimanic Agents. (ATC-Code: N05AN; N05AN01; D11AX04 (Lithium succinate)).
Mechanism of action
Alters cation transport across cell membrane in nerve and muscle cells and influences reuptake of serotonin and/or norepinephrine. Second messenger systems involving phosphatidylinositol cycle are inhibited. Postsynaptic D~2~ receptor supersensitivity inhibited.
Therapeutic use
Management of bipolar disorders. Treatment of mania in bipolar disorder.
Pregnancy and lactiation implications
Cardiac malformations in infant, including Ebstein’s anomaly, associated with use of lithium during 1^st^ trimester of pregnancy. Lithium use should be avoided during 1^st^ trimester. Contraindicated during lactation.
Unlabeled use
Potential augmenting agent for antidepressants. Aggression, post-traumatic stress disorder, conduct disorder in children.
Contraindications
Hypersensitivity to lithium or any component of the formulation. Avoid in severe cardiovascular, renal disease, or with severe debilitation, dehydration, or sodium depletion. Pregnancy.
Warnings and precautions
May cause CNS depression. Chronic therapy results in diminished renal concentrating ability. Use with caution in mild-moderate cardiovascular disease, in significant fluid loss (protracted sweating, diarrhea, or prolonged fever), in risk of suicide (suicidal thoughts or behavior), in mild-moderate renal impairment, and in thyroid disease. Use caution in patients receiving medications which alter sodium excretion (e.g. diuretics, ACEIs, NSAIDs), or receiving neuroleptic medications; syndrome resembling NMS associated with concurrent therapy. Neuromuscular-blocking agents should be administered with caution (response might be prolonged). Use with caution in the elderly. Lithium toxicity closely related to serum concentrations and can occur at therapeutic doses.