Drugs that normalize the re-uptake of serotonin, norepinephrone, dopamine, and acetylcholine. These are used for:
- Manic period of those with bipolar disorder
- Prevention of recurrent episodes of mania and depression
- Schizo-affective disorder
Contraindications
Lithium levels, even at therapeutic ranges (0.6 - 1.2 mEq/L) may result in toxicity. It should be checked every two to three days during the first month of therapy, then weekly and monthly or more when stable.
- Hypersensitivity response to Lithium
- Renal Disease
- Thyroid Disease
Side Effects
- Common:
- GIT Effects: nausea, anorexia, diarrhea
- Weight Gain
- A “metallic taste”
- Fatigue and lethargy
- Polyuria
- Tremors
- Serious:
- Thyroid Impairment: thyroid function studies are done every 3 to 6 months for clients on long-term lithium therapy.
- Renal Impairment
- Toxic:
- Muscle Weakness
- Nausea
- Slurred Speech
- Agitation, Ataxia
- Vomiting
- Diarrhea, Drowsiness
- Severely Toxic:
- Coma
- Altered Level of Consciousness
- Arrhythmia
- Seizure
- Stupor
- Spastic Muscles
- Hypotension
- Renal Failure
- Treatment of Lithium Toxicity: monitor lithium levels, VS, electrolytes, BUN and Creatinine (renal function). Withhold any further doses. Prepare for hemodialysis if indicated for severe toxicity.
- Prevention of Lithium Toxicity:
- Regular appointments for blood studies should be held. Advise the patient about the signs of and to report for toxicity.
- Maintain adequate fluid and electrolytes (sodium; 2g/d) intake.
- Restrict caffeine intake.
- Be cautious of patients who have diarrhea, polyuria, vomiting, diaphoresis, and a low salt diet as these may increase incidence of lithium toxicity.