What should you watch out when taking lithium?

Call your doctor right away if you have diarrhea, vomiting, drowsiness, muscle weakness, tremors, unsteadiness, or other problems with muscle control or coordination. These may be symptoms of lithium toxicity. Make sure your doctor knows if you have a heart disorder called Brugada syndrome.

What should be monitored when taking lithium?

Regular blood tests are necessary to check lithium levels and to make sure you are taking the right dose. They will be checked weekly or fortnightly at first. Once levels of lithium in the blood are steady, they will be checked regularly (typically 3 monthly), usually 12 hours after the last dose.

What should you avoid when taking lithium?

Avoid drinking alcohol or using illegal drugs while you are taking lithium. They may decrease the benefits (e.g., worsen your condition) and increase adverse effects (e.g., sedation) of the medication. Avoid low sodium diets and dehydration because this can increase the risk of lithium toxicity.

What is the most concerning side effect of lithium?

The most concerning side effects of long term lithium use are hypothyroidism and kidney problems. According to a 2015 review article , these side effects are most likely to affect women below the age of 60 years. They are also more common among people with higher-than-average concentrations of lithium in the blood.

What are the 3 main symptoms of lithium toxicity?

Symptoms of lithium toxicity include severe nausea and vomiting, severe hand tremors, confusion, and vision changes. If you experience these, you should seek immediate medical attention to check your lithium levels.

MY EXPERIENCE ON LITHIUM!!! | Bipolar Meds Series

What are the two major long-term risks of lithium therapy?

Lithium also exerts antisuicidal, immunomodulatory, and neuroprotective effects. The main problems associated with long-term lithium treatment include kidney, thyroid, and probably cognitive issues.

What puts you at risk for lithium toxicity?

Risk factors for lithium toxicity include age older than 50 years, abnormal thyroid function, and impaired renal function. Long-term lithium use increases the risk of lithium-induced nephrogenic diabetes insipidus, which causes loss of renal urine-concentrating ability and increased risk of lithium intoxication.

What triggers lithium toxicity?

Lithium is a prescription medicine used to treat bipolar disorder. This article focuses on lithium overdose, or toxicity. Acute toxicity occurs when you swallow too much of a lithium prescription at one time. Chronic toxicity occurs when you slowly take a little too much of a lithium prescription every day for a while.

Why can't you drink with lithium?

People taking lithium should avoid drinking alcohol. Not only can alcohol worsen bipolar disorder symptoms, but it can also intensify side effects caused by lithium, including dizziness and drowsiness. Additionally, taking lithium while drinking may make the medication less effective, leading to more mood swings.

What should a nurse monitor in a patient taking lithium?

Then, check lithium levels every 2 to 3 months for six months. It is also important to monitor patients for dehydration and lower the dose when there are signs of infection, excessive sweating, or diarrhea. Toxic levels are when the drug level is more than 2 mEq/L.

What should the nurse monitor with lithium?

Renal function – Because reduced renal function can contribute to lithium toxicity, you will monitor creatinine, BUN, creatinine clearance and GFR periodically throughout therapy.

Does lithium require regular blood monitoring?

Lithium levels should be checked every 3 to 6 months and eGFR and TFTs should be checked every 6 months. More frequent tests may be required in those who are prescribed interacting drugs. Weight (or BMI) should also be monitored (see table 2).

Does lithium cause weight gain?

2) Although not very common, weight gain is another adverse effect seen with chronic use of lithium. 3–5) An early study had found that lithium maintenance therapy stimulated weight gains of over 10 kg in 20%, which was attributed to increased thirst in majority of individuals.

Why do people quit lithium?

Adverse effects were the most common cause for lithium discontinuation. Among the adverse effects, diarrhoea, tremor, creatinine increase, polyuria/polydipsia/diabetes insipidus and weight gain were the top five reasons for discontinuing lithium.

What foods interact with lithium?

Foods that alkalinize the urine may increase elimination of lithium from the body, potentially decreasing the actions of the drug. Urine-alkalinizing foods include dairy products, nuts, fruits, vegetables (except corn and lentils), and others.

What does lithium toxicity look like?

Clinical signs of lithium toxicity include nausea, vomiting, diarrhea, tremor, dysarthria, nystagmus, ataxia, and slurred speech. Patients will also exhibit alterations in the level of consciousness, which may vary from confusion to agitation, delirium, and coma.

How long does it take to develop lithium toxicity?

The standard therapeutic range for serum lithium levels normally falls between 0.6 and 1.2 mEq/l . To diagnose toxicity in a person who normally takes lithium, doctors should take their serum levels 6 to 12 hours after their last dose.

What is normal lithium level for bipolar?

For adults with bipolar disorder there was consensus that the standard lithium serum level should be 0.60‐0.80 mmol/L with the option to reduce it to 0.40‐0.60 mmol/L in case of good response but poor tolerance or to increase it to 0.80‐1.00 mmol/L in case of insufficient response and good tolerance.

Is there a safer alternative to lithium?

Sodium-ion batteries are an emerging technology with promising cost, safety, sustainability and performance advantages over commercialised lithium-ion batteries.

What organs can lithium damage?

Lithium has adverse effects on the kidneys, thyroid gland and parathyroid glands, necessitating monitoring of these organ functions through periodic blood tests. In most cases, lithium-associated renal effects are relatively mild.

What is an alternative to lithium for bipolar?

The ones that treat bipolar depression are cariprazine (Vraylar), lurasidone (Latuda), olanzapine-fluoxetine combo (Symbyax), and quetiapine (Seroquel). Among them, lurasidone offers a good balance of efficacy and tolerability.

Does lithium make your stomach big?

Edema or bloating

Lithium carbonate's other side effects are sodium retention when the body holds on to extra salt leading to polydipsia (increased thirst). This side effect causes a person to consume more fluids, leading to bloating and edema (swelling), known as water weight gain.

Is lithium a last resort?

Lithium remains first choice as maintenance treatment for bipolar affective disorder. Yet, about half of all individuals may stop their treatment at some point, despite lithium's proven benefits concerning the prevention of severe affective episodes and suicide.

Does lithium affect appetite?

Lithium seems to influence appetite slightly although it is responsible for the gain in weight in a fourth of the treated outpatients. Half of the subjects consider that lithium modifies their sexuality towards a decrease of the desire without modifying their capacities of realization.

What labs do you need before lithium?

Before starting lithium obtain baseline complete blood cell counts with differential (CBC with diff); urinalysis; blood urea nitrogen; creatinine; serum calcium levels; thyroid function tests; and pregnancy test for females of childbearing age.