Works on the central nervous system. Used to treat manic episodes and for bipolar disorder maintenance.
Lithium causes serotonin receptor blockage
Can decrease neuronal atrophy or increase neural growth
Influences the flow of sodium throughout the body (sodium affects mania)
Pregnancy Category: D
Interactions
Antidepressants
Antipsychotics
MAOIs
Diuretics
NSAIDs
Anticholinergics
Fentanyl
St. John’s Wort
Tramadol
Signs & Symptoms
Loss of appetite
Increased urination/issues with vision
Thirst/tremors
Hypothyroidism
Interactions
Upset stomach (N/V, diarrhea)
Muscle weakness
Skin (acne, rash)
Serotonin Syndrome: hallucinations, fever, twitching, loss of coordination, agitation, fast heart rate.
Nursing Interventions
Monitor Lithium levels 5 days after starting lithium therapy then every 1-3 months
-older patients
-morning results
- Educate: No breastfeeding
- Monitor CBC, electrolytes, kidney studies and thyroid function tests
- Take with meals and avoid dehydration
- Tremors: administer propranolol
- Polyuria: Sparing diuretics, increase fluids
- I and O
- Hypothyroidism: T3T4, give levothyroxine
Toxicity
Early: (<1.5mEq/L ) diarrhea, NV, polyuria, fine tremor, slurred speech
Advanced: (1.5-2mEq/L) confusion, poor coordination, coarse tremors
Severe: (2-2.5mEq/L) tinnitus, seizures, coma, death
Administer an emetic, gastric lavage, prepare patient for hemodialysis