Lithium

In laymen terms how does lithium work?

• Works by changing the way your brain processes signals to help stabilise your mood

What forms is lithium prescribed in?

• Tablet

• Liquid

What should you inform the patient when taking their meds?

• Swallow with plenty of water

What time of day should patients take lithium?

• At night but not essential

What advise for administration of medications ?

• Take lithium same time every day

• If you miss a dose don’t take a double dose the next time, take the next dose as usual

• Patient should be given a lithium record book for their blood test results and doses , its important that you keep this book with you when travelling in case you require medical assistance

How should you explain lithium monitoring to a patient ?

• Once you start taking the new medication , we’ll need to test the levels of your blood once a week

• It’s important that the blood test is 12 hours after your previous dose

• Once stable we will ease your level of lithium in your blood every 3 months

• We need to monitor your urea and electrolytes , calcium and thyroid function twice a year

Why does thyroid levels need to be monitored?

• Can cause your thyroid to be underactive

What are common side effects ?

• increase thirst

• Increased volume and frequency of urination

• Tiredness

• Weight gain

• Fine tremor

What are the side effects of lithium toxicity

• confusion

• Drowsiness

• Vision problems

• Difficulty speaking

• Seizures

• Excessive thirst and urination

What’s the mnemonic to remember the side effects ?

• Lethargy

• Insipidus (diabetes)

• Tremor

• Hypothyroidism

• Insides (gastrointestinal)

• Urine (increased)

• Metallic taste

If a female of child bearing age is taking lithium , what should you tell them?

• To sure reliable method of contraception

What are some important interactions?

• NSAIDS

• ACEi/ARB

• Erythromycin

• Metronidazole

• Thiazides

• SSRIs

• TCAs

• Amiodarone

Can you change brands?

• No keep to the same

What’s the reference range?

• 0.4 - 1 mmol/L