Lithium

Lithium carbonate
Lithium citrate

Indications

3 episodes of mania.

Method of administration

Starting

Starting commits to minimum 2 years of treatment.
FBC: leukocytosis. U&E: renal function. Thyroid function.

Monitoring

Small therapeutic range. 0.4–1.0 mmol/l. Toxicity: >1.5 mmol/l. Severe toxicity: >2.0 mmol/l

Toxicity & overdose

Mild toxicity: tremor, ataxia, diarrhoea, dysarthria, nystagmus. Severe toxicity: renal failure, hypotension, convulsions, coma.

Discontinuation

Gradual withdrawal over a few weeks.