Bipolar Disorder - Therapy and Lifestyle Changes

Highlights	Prognosis	Other Treatments
Introduction	Symptoms	Psychotherapy and Lifestyle Changes
Causes	Diagnosis	Resources
Risk Factors	Treatment	References
Complications	Medications

Medications

Lithium

Lithium (Eskalith, Lithobid, generic) is the most widely used and studied mood stabilizing drug for bipolar disorder. Lithium is extremely helpful for most patients. It can help control symptoms of mania and prevent recurrent manic episodes. It can also help treat bipolar depression and reduce suicide risk.

Administration of Lithium. Lithium may take several weeks to become fully effective, so patients should not expect an immediate response during an acute episode.

Lithium blood levels should be monitored regularly to determine the best dosage and to prevent lithium toxicity. In addition, the doctor needs to monitor the patient’s kidney and thyroid function. Lithium can cause low thyroid levels (hypothyroidism), which can affect mood. Some patients need to take thyroid medication while on lithium.

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Lithium Toxicity. If lithium levels in the blood are too high, lithium toxicity (overdose) can occur. Signs of toxicity include:

Trembling hands
Nausea
Increased urine output
Blurred vision
Some loss of coordination

Severe reactions occurring at very high blood levels include:

Vomiting
Convulsions
Uncontrolled jerky movements in arms and legs
Stupor
Coma
Very high blood levels of lithium can be fatal

Side Effects. Mild nausea and diarrhea are common initial side effects of lithium that usually go away after a few weeks. Long-term side effects may include:

Weight gain, which can lead to increased risk for diabetes
Increased thirst
Increased urination
Hair loss
Skin rashes and acne
Low thyroid function (symptoms include dry skin, sensitivity to cold temperatures, hair loss, weight gain)
Impaired memory and poor concentration

Drug Interactions. Because lithium is eliminated from the body by the kidneys, any drugs or dietary factors that slow the kidneys' actions may increase lithium blood levels and should be used with great caution. Such drugs include: