Lithium is used for the treatment of manic/depressive bipolar and depressive disorders. Lithium is a positively charged element or particle that is similar to sodium and potassium. It interferes at several places inside cells and on the cell surface with other positively charged atoms such as sodium, potassium, calcium and magnesium which are important in many cellular functions. Lithium is used to reduce the frequency and severity of manic states.

Lithium may also reduce the frequency and severity of depression in bipolar disorder. It is not known how lithium works to stabilize a persons mood. However, it does act on the central nervous system. It helps you to have more control over your emotions and helps you cope better with the problems of living.

Lithium interferes with the synthesis and reuptake of chemical messengers by which nerves communicate with each other neurotransmitters. Lithium also affects the concentrations of tryptophan and serotonin in the brain. In addition lithium increases the production of white blood cells in the bone marrow. Lithium effects usually begin within one week of starting treatment and the full effect is seen by 2 to 3 weeks.

Lithium has been used since the 1950s. The currently most frequently used preparation lithium carbonate was not approved by the FDA until 1970.

However, before taking Lithium Carbonate i.e. Lithium medication, ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient and read it carefully. Talk to your doctor about all the possible risks of taking Lithium medication. However, Lithium may also be used for purposes other than those listed in this medication guide. Hence, for more information, consult your doctor and your medical pharmacist.

Follow the directions given by the doctor exactly for the usage of the Lithium i.e. Lithium Carbonate medication and also read the prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand.

Generic Lithium i.e. Lithium Carbonate is generally taken with food although its absorption is not markedly affected by the presence of food. Doses vary widely and are adjusted based on measurements of the levels of lithium in the blood. Early in therapy dose adjustments are made as often as every 5 to 7 days to establish the correct dose. Patients with kidney diseases excrete less lithium from the body and therefore require lower doses.

If you wish to use the medication for your children, please contact your pediatrician for the dosage.

If you notice any of the symptoms, which seem severe or persistent to you, please contact your doctor immediately. However, your doctor may need to monitor you carefully for side effects and alter the doses if necessary.

The most common side effects that can occur in persons taking lithium are fine hand tremor dry mouth, altered taste perception, weight gain, increased thirst, increased frequency of urination, mild nausea or vomiting, impotence, decreased libido, diarrhea and kidney abnormalities. Many of the gastrointestinal side effects nausea, taste alterations, diarrhea often disappear with continued therapy. Additionally they may be less common if lithium is taken in divided doses with meals. If diarrhea or excessive urination lead to dehydration lithium toxicity is possible. Lithium can also cause changes in the electrocardiogram low blood pressure and decreased heart rate.

The following side effects suggest that lithium blood levels may be too high and that the dose of lithium may need to be reduced after confirmation by measurement of lithium levels in blood: coma, loss of appetite, visual impairment, tiredness, muscle weakness, muscle fasciculations i.e. twitches, tremor, unsteady gait, confusion seizure, arrhythmias, slurred speech etc.

About 1 in every 25 persons who receives lithium develops a goiter, an enlarged thyroid gland. However, Hypothyroidism i.e. low thyroid hormone levels has been reported. Signs of hypothyroidism may include dry rough skin, hair loss, hoarseness, mania, mental depression, increased sensitivity to cold and swelling of the feet lower legs and neck.

Inform your doctor if you experience any of these side effects or some new side effects occur which appear too bothersome to you.

Inform your doctor if you are allergic to the formulation of this medication or any other medication in any other form and also inform your doctor about any other medication you may be taking in any other form, as they may affect the way your medicine works.

NSAIDs e.g. ibuprofen i.e. Motrin and Advil, naproxen Naprosyn, Aleve, indomethacin i.e. Indocin, nabumetone i.e. Relafen, diclofenac i.e. Voltaren, Cataflam and Arthrotec, ketorolac i.e. Toradol reduces the kidneys ability to eliminate lithium and lead to elevated levels of lithium in the blood. This can lead to side effects. Blood concentrations of lithium may need to be measured for 4 to 7 days after an NSAID is either added or stopped during lithium therapy. Aspirin and sulindac Clinoril do not appear to affect lithium concentrations in the blood.

Diuretics water pills should be used cautiously in patients receiving lithium. Diuretics that act at distal tubule e.g. hydrochlorothiazide, spironolactone i.e. Aldactone, triamterene i.e. Dyrenium, Dyazide and Maxzide can increase blood concentrations of lithium. Diuretics that act at the proximal tubule e.g. acetazolamide i.e. Diamox are more likely to reduce blood concentrations of lithium. Diuretics such as furosemide i.e. Lasix and bumetanide i.e. Bumex may have no affect on lithium concentrations in blood.

ACE inhibitors e.g. enalapril i.e. Vasotec, lisinopril i.e. Zestril and Prinivil, benazepril i.e. Lotensin, quinapril i.e. Accupril, moexipril i.e. Univasc, captopril i.e. Capoten, ramipril i.e. Altace may increase the risk of developing lithium toxicity by increasing the amount of lithium that is reabsorbed in the tubules of the kidney and thereby reducing the excretion of lithium. When carbamazepine i.e. Tegretol and lithium are used together some patients may experience side effects including: dizziness, lethargy and tremor. Central nervous system side effects also may occur when lithium is used with antidepressants for example: fluoxetine i.e. Prozac, sertraline i.e. Zoloft and paroxetine i.e. Paxil, fluvoxamine i.e. Luvox, amitriptyline i.e. Elavil, imipramine i.e. Tofranil desipramine i.e. Norpramin.

Medications which cause the urine to become alkaline the opposite of acidic can increase the amount of lithium that is lost into the urine. This results in lower blood concentrations of lithium and reduces the effects of lithium. Such drugs include: potassium acetate, potassium citrate, sodium bicarbonate and sodium citrate.

Caffeine appears to reduce serum lithium concentrations and side effects of lithium have increased in frequency when caffeine is consumed.

Both diltiazem i.e. Cardizem-CD, Tiazac and Dilacor-XR and verapamil i.e. Calan-SR, Isoptin-SR, Verelan, Covera-HS have been reported to have variable effects on lithium levels in blood. In some patients there may be decreased lithium blood levels and in others lithium toxicity.

Methyldopa i.e. Aldomet may increase the likelihood lithium toxicity.

Various reactions have resulted when lithium is administered with phenothiazines for example: chlorpromazine i.e. Thorazine, thioridazine i.e. Mellaril, trifluoperazine i.e. Stelazine or with haloperidol i.e. Haldol. Such reactions have included: delirium, seizures, encephalopathy, high fever or certain neurologic reactions that affect movement of muscles, called extrapyramidal symptoms.

Lithium can cause goiter or hypothyroidism. The use of lithium with potassium iodide can increase the likelihood of this adverse reaction.

The use of the beta-blocker, propranolol i.e. Inderal, with lithium can lead to a slow heart rate and dizziness. Other beta-blockers for example: metoprolol i.e. Lopressor, atenolol i.e. Tenormin also may interact with lithium and be associated with a slow heart rate.

Moreover, Lithium i.e. Lithium Carbonate may also interact with some kind of foods, varied medications, herbal products, nutritional supplements, vitamins, other OTC medicines, some vaccinations etc. Acquire more information about the interactions of the Lithium medication from your doctor and the medical pharmacists.

In case of overdose call your local poison control center at 1-800-222-1222.
If the suffering patient has collapsed or is not breathing call local emergency services at 911. Canadian residents should call their local poison control center directly.

Do not allow any other person to use your medication without getting doctor’s prescription themselves and also avoid using this medicine for other health conditions on your own. Keep the medicine away from the children and pets.

Also inform your doctor, if you are pregnant or are breast feeding. If you conceive during the course, inform your doctor immediately. Do not share your medicines with anyone, even if they have the same symptoms, for it may harm them. Do not begin, increase, decrease, or stop using this medicine on your own. In short discuss your complete medical history with your doctor, before taking the medicine.

Remember, it is very important to keep regular appointments with your doctor to study the way your body is responding to the course. And if you are going to have a surgery, tell your health care professional that you are using Lithium medication.
Carry with you at all times an ID card mentioning your name, the medicine you are taking, the dosage, the name of the person and your health care professional they should call in case of an emergency.

Also avoid alcohol and alcohol containing beverages whilst on a course with this medication.

And in case, if you wish to use the medicine in children, please contact your pediatrician for sure before its use.

If you missed the Eskalith Lithobid i.e. Lithium medication dose, do take the medicine immediately provided that there is ample of time in between the next dose. However, if it is almost time for the next dose skip the missed dose and continue your regular dosing schedule. Never double your doses to cope up with the missed. And in case, if you miss your one or two consecutive doses consult to your doctor or physician for guidance and continue further.

Remember, if it is within 4 hours i.e. about 6 hours for extended-release tablets or slow-release capsules of your next dose, skip the missed dose and go back to your regular dosing schedule.

Generic Lithium i.e. Lithium Carbonate medication is used for bipolar affective disorder manic-depressive illness and has also been used for unipolar depression.

However, it may also be used to treat some other medical conditions which may be determined by your doctor accordingly and consult a pediatrician for the use of this medication in children.

The generic Lithium i.e. Lithium Carbonate medication may be prescribed for other uses also, so ask your doctor or pharmacist for more information about the Lithium i.e. Lithium Carbonate medication.

Store generic Lithium i.e. Lithium Carbonate, at room temperature below 15-30°C and 59-86°F. Keep the medicine in the container, it came in and always keep it tightly closed. Check Expiry date without fail. Keep all medicines away from women, newborns, children and pets. Do not freeze in any case. Also, keep it away from heat, dampness and direct light. Heat or moisture may cause the medicine to break down. When the medicine is not in use or outdated it should be discarded. Take help of your pharmacist in disposing this medicine properly. In any case, do not store the Lithium medication in the bathroom.

Following precautions must be taken during consuming generic Lithium i.e. Lithium Carbonate:

1. Inform your doctor if you have or have ever had: kidney disease, lung disease, liver disease, heart disease, diabetes, low or high blood pressure, asthma, heart attack, irregular/slow heartbeat or any other severe disease etc. Also inform, if you drink alcoholic beverages or are a tobacco smoker etc.

2. Also acknowledge your doctor if you need to undergo any kind of surgery, including dental surgery or need an x-ray procedure that uses contrast agents. So, inform your doctors immediately about it, so that the doctor can decide whether to continue taking Lithium medication or stop it during the surgery.

3. Let the doctor also know, if you are in-taking or are planning to take any prescribed or non prescribed medicines, health supplements or any other OTC medications, vitamins etc. This includes any medicines containing ibuprofen, naproxen, or ketoprofen.

4. Do not use the Lithium i.e. Lithium Carbonate medication, if you have any kind of allergy to it or to any ingredients of it and tell your doctor or pharmacist about the allergy and get treated.

5. Tell your doctor if you are pregnant or breast feeding before taking Lithium medication. Hence also, inform your doctor immediately when you plan to conceive, or become pregnant during the course.

6. Do not share the drug with others unless they are prescribed by the doctor themselves. And if your symptoms of side effects do not improve in few weeks or if they become worse and bothersome, check these conditions immediately with your doctor.

7. Please, use the Lithium medicine in the prescribed amount and do not overdose it or use it for the longer period of time. Do not discontinue on your own and consult your doctor before doing so to avoid further problems.

8. Regularly, keep your appointments with your doctor and keep an eye on the progress or side effects that has been noticed during the complete course.

9. Also, avoid smoking and consuming alcohol and alcohol containing beverages during the complete course to achieve good results.

10. Generic Lithium may cause some people to become dizzy, drowsy, or less alert than they are normally. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or are not alert.

11. Use extra care in hot weather and during activities that cause you to sweat heavily, such as hot baths, saunas, or exercising . The loss of too much water and salt from your body could lead to serious side effects from this medicine.

12. If you have an infection or illness that causes heavy sweating, vomiting, or diarrhea, check with your doctor. The loss of too much water and salt from your body could lead to serious side effects from lithium.

13. Do not go on a diet to lose weight and do not make a major change in your diet without first checking with your doctor. Improper dieting could cause the loss of too much water and salt from your body and could lead to serious side effects from this medicine.

14. For patients taking the slow-release capsules or the extended-release tablets: Do not use this medicine interchangeably with other lithium products. And it is important that you and your family know the early symptoms of lithium overdose or toxicity and when to call the doctor.

15. For more information, contact your doctor and your pharmacists and also discuss the risks and benefits of the generic Lithium.