Lithobid (Lithium Carbonate)

Lithobid Review

Lithium in pharmacology refers to use of the lithium ion, as a drug. A number of chemical salts of lithium are used medically as a mood stabilizing drug, primarily in the treatment of bipolar disorder, where they have a role in the treatment of depression and particularly of mania, both acutely and in the long term. As a mood stabilizer, lithium is probably more effective in preventing mania than depression, and may reduce the risk of suicide.In depression alone (unipolar disorder) lithium can be used to augment other antidepressants.

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Lithobid Drug Class and Mechanism

Unlike other psychoactive drugs, Li+ produces no obvious psychotropic effects (such as euphoria) in normal individuals at therapeutic concentrations. The precise mechanism of action of Li+ as a mood-stabilizing agent is currently unknown. It is possible that Li+ produces its effects by interacting with the transport of monovalent or divalent cations in neurons. However, because it is a poor substrate at the sodium pump, it cannot maintain a membrane potential and only sustains a small gradient across biological membranes. Yet Li+ is similar enough to Na+ in that under experimental conditions, Li+ can replace Na+ for production of a single action potential in neurons. Recent research suggests three different mechanisms which may act together to deliver the mood-stabilizing effect of this ion . An increasing number of scientists have come to the conclusion that the excitatory neurotransmitter glutamate is the key factor in understanding how lithium works. Other mood stabilizers such as valproate and lamotrigine exert influence over glutamate, suggesting a possible biological explanation for mania.[citation needed] The other mechanisms by which lithium might help to regulate mood include the alteration of gene expression[6] and the non-competitive inhibition of an enzyme called inositol monophosphatase. An unrelated proposed mechanism of action put forth at the University of Pennsylvania in 1996 posits that lithium ion deactivates the GSK-3B enzyme.The regulation of GSK-3B by lithium may affect the circadian clock -- and recent research (Feb 2006) seems to support this conclusion. When GSK-3B is activated, the protein Bmal1 is unable to reset the "master clock" inside the brain; as a result, the body's natural cycle is disrupted. When the cycle is disrupted, the routine schedules of many functions (metabolism, sleep, body temperature) are disturbed. Lithium may thus restore normal brain function after it is disrupted in some people. The complete mechanism related to mood in this mechanism is not hypothesized. Another mechanism proposed in 2007 is that lithium may interact with nitric oxide (NO) signalling pathway in the central nervous system which plays a crucial role in the neural palsticity. There is evidence that the NO system could be involved in the antidepressant effect of lithium in the Porsolt forced swimming test in mice

Lithobid Uses

Several days to weeks may pass before you feel the full benefit of this medicine. Do not stop taking this medicine with checking with your doctor. Keep all laboratory appointments while taking this medicine. Check with your doctor before restricting your salt intake. After exercising, or if you have a fever, eat salty foods to replace sodium lost through sweating. Follow the directions for using this medicine provided by your doctor. Store this medicine at room temperature, in a tightly-closed container, away from heat and light. Take this medicine everyday at evenly spaced intervals. If you miss a dose of this medicine, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once. Take this medicine with food or milk. Drinking extra fluids (8 to 12 glasses of water or other liquid) while you are taking this medicine is recommended. IF USING THIS MEDICINE FOR AN EXTENDED

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Lithobid Side Effects

Mild adverse effects can occur even if serum lithium levels are 1 mmol/L. Initial postabsorptive symptoms including g.i. discomfort, nausea, vertigo, muscle weakness, and a dazed feeling frequently disappear after stabilization of therapy. More common and persistent side effects: fine hand tremor, fatigue, thirst, polyuria. Mild to moderate toxic reactions occur at lithium levels of 1.5 to 2 mmol/L; moderate to severe reactions at levels > 2 mmol/L. Progressive intoxication may be manifest3ed by confusion, increasing disorientation, muscle twitchings, hyper-reflexia, nystagmus, seizures, diarrhea, vomiting, and eventually coma and death.

Lithobid Pregnancy

Adverse effects on implantation in rats, embryo viability in mice, and metabolism in vitro of rat testes and human spermatozoa have been attributed to lithium, as have teratogenicity in submammalian species and cleft palates in mice. In humans, lithium carbonate may cause fetal harm when administered to a pregnant woman. Data from lithium birth registries suggest an increase in cardiac and other anomalies, especially Ebsteins anomaly. If this drug is used in women of childbearing potential, or during pregnancy, or if a patient becomes pregnant while taking this drug, the patient should be apprised of the potential hazard to the fetus. Lithium is excreted in human milk. Nursing should not be undertaken during lithium therapy except in rare and unusual circumstances where, in the view of the physician, the potential benefits to the mother outweigh possible hazards to the child.

Lithobid Overdose

The toxic levels for lithium are close to the therapeutic levels. It is therefore important that patients and their families be cautioned to watch for early toxic symptoms and to discontinue the drug and inform the physician should they occur.

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