Lithium remains first choice as maintenance treatment for bipolar affective disorder. Yet, about half of all individuals may stop their treatment at some point, despite lithium's proven benefits concerning the prevention of severe affective episodes and suicide.
If you've been taking lithium for some time, it can cause weight gain. It can also cause problems with your kidneys or thyroid gland. Common signs of an underactive thyroid are tiredness, weight gain and feeling depressed.
(3). It has long been known that lithium has toxic effects on the thyroid gland and the kidneys. The thyroid toxicity, caused primarily by lithium's interference with thyroid hormones' release from the gland (19) affects up to 19% of treated patients (20).
Lithium is especially recommended for patients who suffer from severe depression with a high risk of suicide.
In addition, lithium is used as monotherapy to treat acute episodes of unipolar depression and as maintenance treatment to prevent recurrence of unipolar depressive episodes. Lithium was first used by psychiatrists in the mid-1800s [2]. The first controlled trial of lithium for unipolar depression was in 1968.
We found no reliable evidence of any robust differences between lithium and antidepressants but nor could we reliably exclude the possibility of clinically significant differences.
The ones that treat bipolar depression are cariprazine (Vraylar), lurasidone (Latuda), olanzapine-fluoxetine combo (Symbyax), and quetiapine (Seroquel). Among them, lurasidone offers a good balance of efficacy and tolerability.
Lithium salts have been used to augment antidepressants for the past 25 years. A study found that within 48 hours, 8 patients, who had previously shown no response to tricyclic antidepressants had a dramatic response to lithium salts.
Depression and quality of life scores started to improve quickly within the following month. Two months after introduction of lithium, full remission was reported.
Lithium is a mood stabilising medicine used to treat certain mental illnesses, such as: mania (feeling highly excited, overactive or distracted) hypomania (like mania, but less severe) bipolar disorder, where your mood changes between feeling very high (mania) and very low (depression)
The reputation that lithium got for being "toxic," "mind numbing," and so forth, certainly those things have an element of truth to them. But they come from earlier studies where people were kept at a much higher doses and blood levels of lithium.
Some side effects are common when people first start lithium, such as: Tremors (shakiness), especially in the hands. Dry mouth. Feeling thirstier.
Lithium's benefits
In treating acute manic episodes, lithium's response rate is in the range of 70-80%.
It is not known how lithium works to stabilize a person's mood. However, it does act on the central nervous system. It helps you to have more control over your emotions and helps you cope better with the problems of living.
If you have to stop taking lithium for any reason, talk to your GP about taking an antipsychotic or valproate instead.
It takes about 1 to 3 weeks for lithium to show the effects and remission of symptoms. Many patients show only a partial reduction of symptoms, and some may be nonresponders. In cases where the patient does not display an adequate response, consider monitoring plasma levels, and titrating the dose.
But your doctor may prescribe newer antidepressants known as SSRIs (selective serotonin reuptake inhibitors) for treating depression in bipolar disorder – along with lithium or other mood-stabilizing drugs such as valproate, carbamazepine , or an atypical antipsychotic.
One of the side effects of lithium maintenance therapy is weight gain. Scientists believe that lithium-associated weight gain occurs due to various reasons, such as increased thirst, increased appetite, alterations in metabolism, sodium retention, hormonal fluctuations, constipation, and fatigue.
Neurotransmitter Regulation: Lithium increases the activity of calming GABA receptors and decreases the activity of more stimulating dopamine and NMDA receptors, resulting in an overall relaxing, stabilizing effect.
Like many other antipsychotic and antidepressant drugs, lithium may also cause sexual and erectile dysfunction [20,21]. About one-third of bipolar or schizoaffective patients receiving lithium report sexual dysfunction [20,21].
Vraylar (Cariprazine) Is Approved as an Antidepressant 'Add On' The drug may help people with major depressive disorder who are taking an antidepressant but not improving. Cariprazine is thought to work by moderating levels of dopamine and serotonin in the brain. AbbVie Inc.
These medications are often the first line of treatment for bipolar disorder along with psychotherapy. Many times, these medications alone may be enough to keep symptoms in check. A review in the journal Bipolar Disorders found that lithium is the most effective singular treatment for bipolar disorder.
Lithium, anticonvulsants and antipsychotics are the three main types of drug which are used as mood stabilisers.
The oldest and best mood stabilizer is lithium carbonate (lithium). Although this medication is primarily used to treat bipolar disorders, lithium can also be effective in alleviating unipolar depressive symptoms.
The most important use of lithium is in rechargeable batteries for mobile phones, laptops, digital cameras and electric vehicles. Lithium is also used in some non-rechargeable batteries for things like heart pacemakers, toys and clocks.