📋 Indications & Clinical Dosage
Treatment and prophylaxis of mania, Treatment and prophylaxis of bipolar disorder, Treatment and prophylaxis of recurrent depression, Treatment and prophylaxis of aggressive or self-harming behavior:
Adults & Children 12 yr: Usual dose 1800 mg/day in 3-4 divided doses. Dose adjusted to achieve a serum-lithium concentration of 0.4-1 mmol/litre 12 hours after a dose on days 4-7 of treatment, then every week until dosage has remained constant for 4 weeks and every 3 months thereafter, doses are initially divided throughout the day, but once daily administration is preferred when serum-lithium concentration stabilised
⛔ Contraindications
Severe renal, hepatic or cardiac insufficiency, Addisons disease, dehydration, personal or family history of Brugada syndrome, low sodium diets, rhythm disorder, untreated hypothyroidism
⚠️ Precautions & Warnings
Cardiac disease, concurrent ECT, diuretic treatment, elderly (reduce dose), epilepsy, myasthenia gravis, psoriasis, QT interval prolongation, surgery. Review dose as necessary in diarrhoea, vomiting and intercurrent infection. Maintain salt and fluid intake. Monitor renal, cardiac and thyroid function. Treatment should be initiated in hospital. Avoid abrupt withdrawal
🔄 Drug Interactions
Diuretics, NSAIDs, phenytoin, carbamazepine, flupenthixol, haloperidol, diazepam, methyldopa, tetracy-clines.
⚠️ Adverse Reactions / Side Effects
Anorexia, alopecia, arrhythmia, arthralgia, AV block, benign intracranial hypertension, bradycardia, cardiomyopathy, cognitive impairment, dry mouth, dysgeusia, ECGchanges, electrolyte imbalance, GI disturbances, encephalopathy, extrapyramidal side-effects, gastritis, euthyroid goiter, hallucinations, hypersalivation, hyperthyroidism, hypothyroidism, leukocytosis, malaise, memory loss, myalgia, myasthenia gravis, tremor, nephrogenic diabetes insipidus, nephrotic syndrome, oedema, peripheral neuropathy, polydipsia, psoriasis exacerbation, QTinterval prolongation, Raynauds phenomena, renal impairment, sexual dysfunction, sinus node dysfunction, speech disorder, thyroid changes, vertigo, weight changes
🤰 Pregnancy & Lactation Safety
Pregnancy Risk:
Avoid unless potential benefit outweighs risk
Lactation / Breastfeeding:
: Contraindicated, avoid
📚 Official Regulatory & Clinical References
- Drug Regulatory Authority of Pakistan (DRAP): Drug Registration, S.R.O. Price Gazettes & National Essential Medicines List (NEML).
- World Health Organization (WHO): Collaborating Centre for Drug Statistics Methodology (ATC/DDD Index).
- Formulary Standards: British National Formulary (BNF) & Pakistan National Formulary (PNF) guidelines.