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Lithium is available as a 300 mg extended-release tablet.

Lithium is a mood stablizer that is used in the treatment of manic episodes of bipolar disorder or the long-term maintenance treatment of bipolar disorder.

Lithium is a mood stabilizer. It’s not known exactly how Lithium works, but it’s thought to affect the levels of certain chemicals in the brain that regulate mood.

The typical dose of Lithium is 900 mg by mouth 2 times a day, or 600 mg 3 times a day. The total daily dose is 1,800 mg.
For long-term control: The typical dose is 600 mg by mouth 2 times a day. The total daily dose is 1,200 mg. Your provider will adjust your Lithium dose based on if you have kidney problems, how well your bipolar symptoms are responding to the medication, if you’re having side effects, and your blood Lithium level.

Lithium is a safe and effective treatment when used for FDA licensed indications. However, like all medications, they may give you unwanted side effects. You should always discuss potential side effects with your physician to ensure the medication is suitable and right for you.

Common side effects of Lithium:

• Hand trembling
• Excessive urination
• More thirst
• Nausea
• General discomfort when you start treatment
• Tremor
• Muscle twitches
• Restlessness
• Vomiting
• Diarrhea

Serious side effects are rare with Lithium. Contact your healthcare provider immediately if you experience any of the following.

• Serotonin syndrome: fast heart rate, dizziness, sweating, flushing, tremor (shakiness), muscle stiffness, muscle twitching or spasms, uncoordinated movement, distress, seizures, hallucinations, coma
• Lithium toxicity: trouble breathing, seizures, coma, kidney failure, abnormal heart rhythm, dizziness, confusion, blurry vision, poor balance, poor speech, poor coordination
• Kidney damage: more frequent urination, swelling in legs, fatigue
• High pressure in the brain and swelling in the eye: severe headaches behind eyes, ringing in the ears, blurred or double vision, and blindness
• Low blood sodium levels: nausea, fatigue, headache, confusion, disoriented, hallucinations (seeing things that aren’t real), seizures, unconsciousness
• High blood calcium levels: fatigue, muscle weakness, loss of appetite, nausea, vomiting, constipation, bone pain, depression, confusion
• Brugada syndrome (life-threatening heart rhythm problem): abnormal ECG findings, unexplained fainting, and irregular heartbeat (palpitations)

The following medications may interact with Lithium:

• Diuretic-, ACE-, and ARB-induced sodium loss may increase serum Lithium concentrations. Start with
• lower doses of Lithium or reduce dosage, while frequently monitoring serum Lithium concentrations and
• signs of Lithium toxicity
• Concomitant administration of Lithium with serotonergic drugs can precipitate serotonin syndrome. Monitor patients for signs and symptoms of serotonin syndrome, particularly during Lithium initiation. Examples of serotonergic drugs include selective serotonin reuptake inhibitors (SSRI), serotonin and norepinephrine reuptake inhibitors (SNRI), and monoamine oxidase inhibitors (MAOI)
• Concomitant administration of methyldopa, phenytoin, or carbamazepine with Lithium may increase the risk of adverse reactions with these drugs

The following drugs can lower serum Lithium concentrations: acetazolamide, urea, xanthine preparations, and alkalinizing agents such as sodium bicarbonate.

• Concomitant extended use of iodide preparations, especially potassium iodide, with Lithium may produce hypothyroidism
• Concurrent use of calcium channel blocking agents with Lithium may increase the risk of neurotoxicity in the form of ataxia, tremors, nausea, vomiting, diarrhea, and/or tinnitus
• Concurrent use with metronidazole may provoke Lithium toxicity. Patients receiving such combined therapy should be monitored closely
• Concurrent use of fluoxetine with Lithium has resulted in both increased and decreased serum Lithium concentrations. Patients receiving such combined therapy should be monitored closely

Nonsteroidal anti-inflammatory drugs (NSAIDs): Lithium levels should be closely monitored when

• patients initiate or discontinue NSAID use

Various FDA-approved generic manufacturers

Lithium may cause fetal harm when administered to a pregnant woman. You should talk to your healthcare provider before taking this medication if you are pregnant.

• Lithobid