From the Guidelines
Lithium (lithium carbonate) is primarily used as a mood stabilizer for the treatment of bipolar disorder, specifically for acute mania and maintenance therapy.
Therapeutic Uses
- Bipolar Disorder: Lithium is approved for the treatment of bipolar disorder in adults and children aged 12 years and older, and is often used as a first-line treatment for acute mania and maintenance therapy 1.
- Mood Stabilization: Lithium has been shown to be effective in stabilizing mood and preventing relapse in patients with bipolar disorder, with studies suggesting that it can reduce the risk of relapse by up to 50% 1.
- Suicide Prevention: Lithium has also been found to have a protective effect against suicide in patients with bipolar disorder, with one study showing that it can reduce the rate of suicides and suicide attempts by up to 50% 1.
Important Considerations
- Dosage and Monitoring: Lithium requires careful monitoring of blood levels and dosage to minimize the risk of side effects, with a typical starting dose of 300-600 mg per day and a target blood level of 0.8-1.2 mmol/L 1.
- Combination Therapy: Lithium is often used in combination with other medications, such as antipsychotics or antidepressants, to treat bipolar disorder and other conditions, with studies suggesting that combination therapy can be effective in reducing symptoms and improving outcomes 1.
- Side Effects: Lithium can cause a range of side effects, including nausea, vomiting, and tremors, and can also increase the risk of kidney damage and thyroid problems, highlighting the need for careful monitoring and management 1.
From the FDA Drug Label
INDICATIONS AND USAGE Lithium is indicated in the treatment of manic episodes of Bipolar Disorder. Lithium is also indicated as a maintenance treatment for individuals with a diagnosis of Bipolar Disorder. The therapeutic use of Lithium (lithium carbonate) is for the treatment of manic episodes of Bipolar Disorder and as a maintenance treatment to reduce the frequency and intensity of manic episodes 2.
- Key indications:
- Treatment of manic episodes of Bipolar Disorder
- Maintenance treatment for Bipolar Disorder
From the Research
Therapeutic Use of Lithium
The therapeutic use of lithium, specifically lithium carbonate, is well-established in the treatment of various medical conditions. Some of the key uses of lithium include:
- Mood stabilization in the treatment of bipolar disorder 3, 4, 5, 6, 7
- Treatment of acute mania and as an adjunctive antidepressant 5
- Maintenance treatment in bipolar disorder 5
- Potential benefits in the treatment of unipolar depression, although less clear than for bipolar maintenance treatment and acute mania 5
- Neuroprotective effects, suggesting potential efficacy in preventing mild cognitive impairment (MCI) and dementia, as well as aiding recovery from strokes 5
- Potential efficacy in preventing cardiovascular disease, osteoporosis, sarcopenia, obesity, and type 2 diabetes 3
- Antiviral effects and potential decrease in cancer risk 5
Low-Dose Lithium Therapy
Low-dose lithium therapy, defined as doses of lithium under the predetermined therapeutic dose used in bipolar disorder treatment, may have beneficial effects on:
- Cardiovascular function 3
- Musculoskeletal function 3
- Metabolic function 3
- Cognitive function 3
- Inflammatory and antioxidant processes of the aging body 3
Pharmacokinetics and Toxicity
Lithium is rapidly and completely absorbed from the gastrointestinal tract after oral administration, with a narrow therapeutic window limited by various adverse effects 4. The effective dose range for lithium is 0.6-1.0 mM in serum, with >1.5 mM potentially toxic 6. Common side effects of lithium include nausea, polyuria, tremor, weight gain, and cognitive dulling 5.