Bipolar Disorder

Question 1

Lithium (Lithicarb OR Quilonum SR)

Answer 1

A) Mood Stabiliser

B)

1. Prevention of MANIC or DEPRESSIVE episodes in BIPOLAR DISORDER
2. Treatment of ACUTE MANIA
3. SCHIZOAFFECTIVE disorder and Chronic SCHIZOPHRENIA
4. Augmentation for Treatment-resistant DEPRESSION

C)
250 - 2500 mg daily (every 12 hours if using Quilonum)
MAX 2.5 g

D)

1. LITHIUM levels***
2. Lithium TOXICITY (blurred vision, diarrhoea, nausea and vomiting, flu-like illness)
3. NEPHROTOXICITY (reduced glomerular filtration rate)
4. RENAL**
5. NSAID use**
6. Serum CALCIUM (hypercalcaemia)
7. THYROID function (hypothyroidism)
8. ECG (T-wave changes)
9. SODIUM levels (hyponatraemia increases risk of toxicity)
10. HYDRATION status (thirst = signs of lithium toxicity)
11. SEROTONIN toxicity
12. Drug INTERACTIONS**

E)
Labels: 5, A* (CR), B (with FOOD)
#Regular BLOOD TESTS are important during treatment
#Be alert for SIGNS of Lithium TOXICITY (extreme thirst, frequent urination, nausea and vomiting), esp. during illness, excessive sweating or low fluid intake
#Avoid taking with HOT DRINKS
#Maintain a NORMAL diet with regular SALT and fluid intake. Drink more NON-ALCOHOLIC fluid during HOT WEATHER to avoid toxicity
#Avoid SODIUM BICARBONATE (found in products such as indigestion medicines and Ural etc) as it makes Lithium LESS effective

S/E:
Metallic taste, nausea, diarrhoea, epigastric discomfort, weight GAIN, faituge, headache, vertigo