Overview
Lithium is an element, the lightest alkali metal, which is combined with CO3 to form a salt — lithium carbonate - when it is used as a drug. Lithium is most commonly used to treat bipolar disorder. Lithium is not a sedative, euphoriant or depressant, and it can be taken at the same time as other medications such as tranquilizers or antidepressants. Lithium is believed to work by:

1. enhancing the uptake of norepinephrine and serotonin into the synaptosomes and thereby reducing the action of both serotonin and norepinephrine
2. reducing release of norepinephrine from synaptic vesicles and inhibiting the production of cyclic AMP (activated protein kinase kinase)

Lithium’s effects are usually noticeable after 1-3 weeks.

Why is this drug prescribed?
Lithium is prescribed for bipolar disorder to control acute manic episodes and which helps to prevent the depressive phase as well. Some symptoms of a manic episode are:

1. rapid thought and speech patterns
2. enthusiasm
3. extreme self-confidence, grandiosity
4. impaired judgment
5. motor hyperactivity
6. reduced need for sleep
7. elation
8. aggressiveness
9. hostility

It is also being used experimentally for schizophrenia.

Other conditions that it has been prescribed for are:

1. chronic hair pulling
2. to prevent cluster headaches
3. to control aggressive behavior
4. to treat Fanconi's aplastic anemia
5. to treat AIDS patient who have a low white blood count
6. to treat patients whose mood disorders affect sex drive

Warnings and Precautions
Lithium salts are toxic; the difference between a helpful dose and a toxic dose is small. Dosage should be carefully monitored.

Suddenly discontinuing lithium may cause withdrawal; doses should be gradually tapered unless lithium is being discontinued because of toxicity.

Because there is no information available about the effects of Lithium on children under twelve years old, Lithium should not be given to anyone under twelve.

For Nursing Mothers: Lithium should be used during pregnancy only if the mother’s disease is severe and safer drugs cannot be used or are not effective. Lithium should be withdrawn for at least the first trimester except when this could seriously endanger the mother. Lithium may cause birth defects (heart abnormality.) Lithium passes into breast milk and should not be taken by nursing mothers.

Contraindications
Lithium should not be used for people with the following medical conditions:

1. severe cardiovascular disease
2. renal disease
3. severe debilitation
4. dehydration
5. sodium depletion
6. brain damage
7. conditions requiring low sodium intake

Adverse Reactions
Lithium may cause the following reactions:

1. thirst
2. gastrointestinal discomfort, diarrhea
3. nausea, vomiting
4. anemia
5. vertigo
6. muscle weakness, psychomotor retardation, changes in muscle tone or tension, fine tremor of the hands, loss of muscular coordination
7. dazed feeling
8. stupor
9. acne
10. increase in amount of urine
11. nephrogenic diabetes insipidus
12. fatigue, drowsiness
13. ringing and/or buzzing of the ears
14. blurred vision
15. loss of appetite
16. restlessness
17. anesthesia of the skin
18. slurred speech
19. blackout spells
20. headache
21. seizures
22. toxic confusional states
23. coma

Interactions with Drugs and Other Substances
Drugs or substances that may interact with Lithium are:

1. medication for asthma, bronchitis, cystic fibrosis, emphysema, or sinusitis
2. MAO Inhibitors (within 14 days) with Lithium can cause serious, even fatal, interactions
3. antithyroid pills or diuretics, furosemide, spironolactone, methyldopa, indomethacin, phenylbutazone and piroxicam — they can increase lithium concentrations
4. acetazolamide, sodium bicarbonate, sodium chloride, theophylline and mannitol can decrease lithium concentrations
5. haloperidol, phenothiazines, carbamazepine, or phenytoin taken with lithium may increase neurotoxicity
6. ACE inhibitors such as Capoten (captopril) may increase lithium levels

http://www.mentalhealth.com/drug/

http://www.healthtouch.com/bin/EContent_HT/showAllLfts.asp?lftname=NMHA095&cid=HT

http://www.psyweb.com/Drughtm/lithiu.html

http://fairlite.com/ocd/medications/lithium.shtml