Lithium has a narrow therapeutic index and regular physical health monitoring is required.  See: CMO(2019)04: National guidance for monitoring Lithium. This includes regular therapeutic drug monitoring.  If lithium toxicity develops seek specialist advice.  Early features include an exacerbation of existing side-effects: nausea, vomiting and tremor.  As toxicity develops further, disorientation and dysarthria appear, followed by convulsions, coma and eventually death from cardiac effects or pulmonary complication.

Note: Lithium
• Always prescribe the same brand of lithium to avoid differences in bioavailablity.
• All patients starting lithium should be offered written information; ensure your patient has a copy of the Choice and Medication lithium patient information leaflet.
• In long-term use lithium has been associated with thyroid disorders and mild cognitive and memory impairment.
• Avoid abrupt cessation of lithium. NICE recommends titrating down over 3 months routinely.

 

LITHIUM CARBONATE

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Modified release tablets (Priadel®) 200mg (5·4mmol lithium/tablet), 400mg (10·8mmol lithium/tablet) (s)

LITHIUM CITRATE

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Oral solution (Priadel®) 520mg/5mL (5·5mmol lithium/5mL) (s)

Editorial Information

Document Id: F107