Description
Lithium is used to treat the manic
stage of bipolar disorder (manic-depressive illness). Manic-depressive
patients experience severe mood changes, ranging from an excited or
manic state (for example, unusual anger or irritability or a false sense
of well-being) to depression or sadness. Lithium is used to reduce the
frequency and severity of manic states. Lithium may also reduce the
frequency and severity of depression in bipolar disorder.
It is not known how lithium works to stabilize a person's mood. However,
it does act on the central nervous system. It helps you to have more
control over your emotions and helps you cope better with the problems
of living.
It is important that you and your family understand all the effects of
lithium. These effects depend on your individual condition and response
and the amount of lithium you use. You also must know when to contact
your doctor if there are problems with the medicine's use. Lithium may
also be used for other conditions as determined by your doctor.
Once a medicine has been approved for
marketing for a certain use, experience may show that it is also useful
for other medical problems. Although these uses are not included in
product labeling, lithium is used in certain patients with the following
medical conditions:
- Cluster headaches
- Mental depression
- Neutropenia (a blood condition in
which there is a decreased number of a certain type of white blood
cells)
Oral
- Capsules (U.S. and Canada)
- Slow-release capsules (Canada)
- Syrup (U.S.)
- Tablets (U.S. and Canada)
- Extended-release tablets (U.S. and
Canada)
Before Using This Medicine
In deciding to use a medicine, the
risks of taking the medicine must be weighed against the good it will
do. This is a decision you and your doctor will make. For lithium, the
following should be considered:
Allergies-
Tell your doctor if you have ever had any unusual or allergic
reaction to lithium. Also tell your health care professional if you are
allergic to any other substances, such as foods, preservatives, or dyes.
Diet—
Make certain your health care professional knows if you are on a
low-sodium or low-salt diet. Too little salt in your diet could lead to
serious side effects.
Pregnancy-
Lithium is not recommended for use during pregnancy, especially
during the first 3 months. Studies have shown that lithium may rarely
cause thyroid problems and heart or blood vessel defects in the baby. It
has also been shown to cause muscle weakness and severe drowsiness in
newborn babies of mothers taking lithium near time of delivery.
Breast-feeding-
Lithium passes into the breast milk. It has been reported to cause
unwanted effects such as muscle weakness, lowered body temperature, and
heart problems in nursing babies. Before taking this medicine, be sure
you have discussed with your doctor the risks and benefits of
breast-feeding.
Children-
Lithium may cause weakened bones in children during treatment.
Older adults-
Unusual thirst, an increase in amount of urine, diarrhea,
drowsiness, loss of appetite, muscle weakness, trembling, slurred
speech, nausea or vomiting, goiter, or symptoms of underactive thyroid
are especially likely to occur in elderly patients, who are often more
sensitive than younger adults to the effects of lithium.
Other medicines-
Although certain medicines
should not be used together at all, in other cases 2 different medicines
may be used together even if an interaction might occur. In these cases,
your doctor may want to change the dose, or other precautions may be
necessary. When you are taking lithium, it is especially important that
your health care professional know if you are taking any of the
following:
- Acetazolamide (e.g., Diamox)
- Antipsychotics (medicine for mental
illness)—Blood levels of both medicines may change, increasing the
chance of serious side effects
- Diuretics (water pills) or
- Inflammation or pain medicine,
except narcotics—Higher blood levels of lithium may occur, increasing
the chance of serious side effects
- Medicine for asthma, bronchitis,
emphysema, sinusitis, or cystic fibrosis that contains the following:
- Calcium iodide or
- Iodinated glycerol or
- Potassium iodide—Unwanted effects on
the thyroid gland may occur
Other medical problems-
The presence of other medical
problems may affect the use of lithium. Make sure you tell your doctor
if you have any other medical problems, especially:
- Brain disease or
- Schizophrenia—You may be especially
sensitive to lithium, and mental effects (such as increased confusion)
may occur
- Diabetes mellitus (sugar
diabetes)—Lithium may increase the blood levels of insulin; the dose
of insulin you need to take may change
- Difficult urination or
- Infection (severe, occurring with
fever, prolonged sweating, diarrhea, or vomiting) or
- Kidney disease—Higher blood levels
of lithium may occur, increasing the chance of serious side effects
- Epilepsy or
- Goiter or other thyroid disease, or
- Heart disease or
- Parkinson's disease or
- Psoriasis—Lithium may make the
condition worse
- Leukemia (history of)—Lithium may
cause the leukemia to occur again
Proper Use of This Medicine
Take this medicine after a meal
or snack. Doing so will reduce stomach upset, tremors, or weakness and
may also prevent a laxative effect.
For patients taking the long-acting
or slow-release form of lithium:
- Swallow the tablet or capsule whole.
- Do not break, crush, or chew before
swallowing.
For patients taking the syrup form
of lithium:
- Dilute the syrup in fruit juice or
another flavored beverage before taking.
During treatment with lithium, drink 2
or 3 quarts of water or other fluids each day, and use a normal amount
of salt in your food
Take this medicine exactly as directed
Sometimes lithium must be taken for 1
to several weeks before you begin to feel better
In order for lithium to work properly,
it must be taken every day in regularly spaced doses as ordered by your
doctordo not stop taking the medicine even if you feel better.
Dosing-
The dose of lithium will be
different for different patients. Follow your doctor's orders or the
directions on the label. The following information includes only the
average doses of lithium. If your dose is different, do not change it
unless your doctor tells you to do so.
The number of capsules or tablets or
teaspoonfuls of syrup that you take depends on the strength of the
medicine. Also, the number of doses you take each day, the time
allowed between doses, and the length of time you take the medicine
depend on the medical problem for which you are using lithium.
- For short-acting oral dosage
forms (capsules, tablets, syrup):
- Adults and adolescents: To start,
300 to 600 milligrams three times a day.
- Children up to 12 years of age:
The dose is based on body weight. To start, the usual dose is 15 to
20 milligrams per kilogram of body weight (6.8 to 9 milligrams per
pound) a day, given in smaller doses two or three times during the
day.
- For long-acting oral dosage
forms (slow-release capsules, extended-release tablets):
- Adults and adolescents: 300 to 600
milligrams three times a day, or 450 to 900 milligrams two times a
day.
- Children up to 12 years of age:
Dose must be determined by the doctor.
Missed dose-
If you miss a dose of this medicine, take it as soon as
possible. However, if it is within 4 hours (about 6 hours for
extended-release tablets or slow-release capsules) of your next dose,
skip the missed dose and go back to your regular dosing schedule. Do not
double doses.
Storage-
To store this medicine:
- Keep out of the reach of children.
- Store away from heat and direct
light.
- Do not store in the bathroom, near
the kitchen sink, or in other damp places. Heat or moisture may cause
the medicine to break down.
- Keep the syrup form of this medicine
from freezing.
- Do not keep outdated medicine or
medicine no longer needed. Be sure that any discarded medicine is out
of the reach of children.
Precautions While Using This Medicine
Your doctor should check your
progress at regular visits
Lithium may not work properly if you
drink large amounts of caffeine-containing coffee, tea, or colas.
This medicine may cause some people to
become dizzy, drowsy, or less alert than they are normally. Make sure
you know how you react to this medicine before you drive, use machines,
or do anything else that could be dangerous if you are dizzy or are not
alert.
Use extra care in hot weather and
during activities that cause you to sweat heavily, such as hot baths,
saunas, or exercising
If you have an infection or illness
that causes heavy sweating, vomiting, or diarrhea
Do not go on a diet to lose weight and
do not make a major change in your diet without first checking with your
doctor
For patients taking the slow-release
capsules or the extended-release tablets:
- Do not use this medicine
interchangeably with other lithium products.
It is important that you and your
family know the early symptoms of lithium overdose or toxicity and when
to call the doctor
Side Effects of This Medicine
Along with its needed effects,
a medicine may cause some unwanted effects. Although not all of these
side effects may occur, if they do occur they may need medical
attention.
Check with your doctor immediately
if any of the following side effects occur:
- Early symptoms of overdose or
toxicity: Diarrhea drowsiness; lack of coordination; loss of
appetite; muscle weakness; nausea or vomiting; slurred speech;
trembling
- Late symptoms of overdose or
toxicity: Blurred vision; clumsiness or unsteadiness; confusion;
convulsions (seizures); dizziness; increase in amount of urine;
ringing in the ears; trembling (severe)
Check with your doctor as soon as
possible if any of the following side effects occur:
- Less common: Confusion, poor
memory or lack of awareness; fainting; fast or slow heartbeat;
frequent urination; irregular pulse; increased thirst; stiffness of
arms or legs; troubled breathing (especially during hard work or
exercise); slurred speech; unusual tiredness or weakness; weight gain
- Rare: Blue color and pain in
fingers and toes; coldness of arms and legs; dizziness; eye
pain; headache; noises in the ears; vision problems
- Signs of low thyroid function:
Dry, rough skin; hair loss; hoarseness; mental depression; sensitivity
to cold; swelling of feet or lower legs; swelling of neck; unusual
excitement
Other side effects may occur that
usually do not need medical attention. These side effects may go away
during treatment as your body adjusts to the medicine. However, check
with your doctor if any of the following side effects continue or are
bothersome:
- More common: Increased
frequency of urination or loss of bladder control—more common in women
than in men, usually beginning 2 to 7 years after start of treatment;
increased thirst; nausea (mild); trembling of hands (slight)
- Less common: Acne or skin
rash; bloated feeling or pressure in the stomach; muscle twitching
(slight)
Other side effects not listed above may
also occur in some patients. If you notice any other effects, check with
your doctor.
Some commonly used brand names are:
In the U.S.-
In Canada-
- Largactil
- Largactil Liquid
- Largactil Oral Drops
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- Largactil Oral Drops
- Novo-Chlorpromazine
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