Litcab

Manic episodes of manic-depressive illness. Maintenance therapy that prevents or diminishes the intensity of subsequent episodes in those manic-depressive patients w/ a history of mania.

Acute treatment of mania & hypomania 1.5-2 g daily for the 1st 5-7 days, together w/ close checks of serum-lithium conc, then dose may be reduced rapidly once the acute phase has passed. Treatment of mania, bipolar disorder, recurrent depression, aggressive or self-harming behaviour Adult Initially 450-675 mg bid. Prophylaxis of mania, bipolar disorder, recurrent depression, aggressive or self-harming behaviour Adult Initially 450 mg bid. Adjust dose to achieve a serum-lithium conc of 0.4-1 mmol/L 12 hr after a dose on days 4-7 of treatment, then every wk until dosage has remained constant for 4 wk & every 3 mth thereafter, doses are initially divided throughout the day, but once-daily administration is preferred when serum lithium conc stabilized.

Should be taken with food: Swallow whole, do not chew/crush.

Severe CV or renal disease & evidence of severe debilitation or dehydration, Na depletion, brain damage.

Decreased Na reabsorption by the renal tubules which could lead to Na depletion. Adequate renal function & salt & fluid intake are essential. Diminished intake of excessive loss of salt & fluids as result of vomiting, diarrhea, perspiration or use of diuretics will also increase lithium retention. Closely monitor serum lithium conc if diuretics are concomitantly used. Pregnancy & lactation.

Anorexia, nausea, vomiting, diarrhea, thirst, dryness of mouth, abdominal pain; general muscle weakness, ataxia, tremor, muscle hyperirritability; slurred speech, blurring of vision, headache, seizures, psychomotor retardation, somnolence, restlessness; arrhythmia, hypotension, cardiac collapse; albuminuria, polyuria, glycosuria; dryness & thinning of the hair, leg ulcers, skin rash; anemia, leukopenia, leukocytosis. Serotonin syndrome.

May increase serum levels w/ metronidazole, NSAIDs including COX-2 inhibitors, ACE inhibitors, angiotensin II receptor antagonists, diuretics (eg, thiazide & loop diuretics), other drugs affecting electrolyte balance (eg, steroids), tetracyclines. May decrease serum levels w/ xanthines (eg, theophylline, caffeine), Na bicarbonate containing products, diuretics (eg, osmotic & carbonic anhydrase inhibitors), urea, calcitonin. May increase risk of neurotoxicity w/ antipsychotics (particularly haloperidol at higher dosages), flupentixol, diazepam, thioridazine, fluphenazine, chlorpromazine & clozapine; methyldopa; triptan derivatives &/or serotonergic antidepressants eg, SSRIs (eg, fluvoxamine & fluoxetine); Ca channel blockers; carbamazepine. Caution if co-administered w/ drugs that prolong the QT interval eg, class IA (eg, quinidine, disopyramide), class III (eg, amiodarone) antiarrhythmic agents, cisapride, antibiotics (eg, erythromycin), antipsychotics (eg, thioridazine or amisulpride). Drugs that lower epileptic threshold eg, SSRIs, TCAs, antipsychotics, anaesth, theophylline. May prolong effects of neuromuscular blocking agents. Phenytoin, indomethacin & other prostaglandin-synthetase inhibitors.

Antidepressants

N05AN01 - lithium ; Belongs to the class of lithium antipsychotics.

Rx