Lithium and other Mood-Stabilizing Drugs

Mood stabilizer are used for the treatment of bipolar affective disorder.

  • Lithium
  • Carbamazepine
  • Sodium Valproate

Lithium:

Lithium is an element with atomic number 3 and weight 7. It was discovered by FJ Cade in 1949 and is a most effective and commonly used drug in the treatment of mania.

Indication:

  • Acute mania
  • Prophylaxis for bipolar and Unipolar mood disorders
  • Schizoaffective disorder
  • Cyclothymia
  • Impulsivity and aggression
  • Other disorder
    • Premature dysphoric disorder
    • Bulimia nervosa
    • Borderline personality disorder
    • An episode of binge drinking
    • Trichotillomania
    • Cluster headaches

Pharmacokinetics:

Lithium is readily absorb with peak plasma level occurring 2-4 hours after a single oral dose of lithium carbonate. Lithium is distributed rapidly in the liver and kidney and more slowly in the muscle, brain and bone. Steady state level are achieved in about 7 days. Elimination is predominantly via kidney. Lithium is reabsorbed in proximal tubule and is influence by sodium balance. Depletion of sodium can precipitate lithium toxicity.

Blood lithium level

  • Therapeutic level = 0.8- 1.2 mEq /L (for treatment of acute mania)
  • Prophylactic level= 0.6-1.2 mEq/L( for relapse in bipolar disorder)
  • Toxic lithium level >2.0 mEq/L

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