Target Health Blog


March 9, 2020


Space-filling model of part of the crystal structure of lithium carbonate, Li2CO3. Color code: Lithium, Li: lilac Carbon, C: grey Oxygen, O: red Structure determined by X-ray crystallography, reported in Z. Kristallogr. (1979) 150, 133-138. Model manipulated and image generated in CCDC Mercury 3.0.
Photo credit: by Ben Mills - Own work, Public Domain, Wikipedia commons

Lithium affects the flow of 1) ___ through nerve and muscle cells in the body. Sodium affects excitation or mania. Lithium is used to treat the manic episodes of bipolar disorder (manic depression), including symptoms that include hyperactivity, rushed speech, poor judgment, reduced need for sleep, aggression, and anger.

Many different lithium salts can be used as medication, including lithium carbonate, lithium acetate, lithium sulfate, lithium citrate, lithium orotate, and lithium gluconate.

Common side effects include increased urination, shakiness of the hands, and increased thirst. Serious side effects include hypothyroidism, diabetes insipidus, and lithium toxicity. Blood level monitoring is recommended to decrease the risk of potential 2) ___. If levels become too high, diarrhea, vomiting, poor coordination, sleepiness, and ringing in the ears may occur. If used during pregnancy, lithium can cause problems in the baby, although lithium appears to be safe to use while breastfeeding. How lithium works is not specifically known.

In the nineteenth century, lithium was used in people who had 3) ___, ___, and ___. Its use in the treatment of mental disorders began in 1948 by John Cade in Australia. It is now on the World Health Organization's List of Essential Medicines, the safest and most effective medicines needed in a health system. It is available as a generic medication, and in 2016 it was the 222nd most prescribed medication in the United States with more than two million prescriptions.

Lithium is used primarily for 4) ____ ____. It is sometimes used when other treatments are not effective in a number of other conditions, including major depression, schizophrenia, disorders of impulse control, and some psychiatric disorders in children. In mood disorders, of which bipolar disorder is one, it decreases the risk of 5) ____.This benefit is not seen with other medications.

Lithium carbonate treatment was previously considered to be unsuitable for children; however, more recent studies show its effectiveness for treatment of early-onset bipolar disorder in children as young as eight. The required dosage is slightly less than the toxic level, requiring close monitoring of blood levels of lithium carbonate during treatment.  A limited amount of evidence suggests lithium carbonate may contribute to treatment of 6) ___ ___ ___ for some people with bipolar disorder.

7) ___ is recommended for the treatment of schizophrenic disorders only after other antipsychotics have failed and it has limited effectiveness when used alone. The results of different clinical studies of the efficacy of combining lithium with antipsychotic therapy for treating schizophrenic disorders have varied. If therapy with antidepressants does not fully treat the symptoms of major depressive disorder 8) (___), then a second augmentation agent is sometimes added to the therapy. Despite not being approved by the FDA for use as an augmentation agent with any antidepressant for the treatment of MDD, lithium has nevertheless been prescribed for this purpose since the 1980s and is one of the few augmentation agents for antidepressants to demonstrate efficacy in treating MDD in multiple randomized controlled trials.

Those who use lithium should receive regular serum level tests and should monitor 9) ___ and kidney function for abnormalities, as it interferes with the regulation of sodium and water levels in the body, and can cause 10) ___. Dehydration, which is compounded by heat, can result in increasing lithium levels. The dehydration is due to lithium inhibition of the action of antidiuretic hormone, which normally enables the kidney to reabsorb water from urine. This causes an inability to concentrate urine, leading to consequent loss of body water and thirst.

ANSWERS: 1) sodium; 2) toxicity; 3) gout, epilepsy, and cancer; 4) bipolar disorder; 5) suicide; 6) substance use disorders; 7) Lithium; 8) (MDD); 9) thyroid; 10) dehydration

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