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As a result, kidney function and blood levels of lithium are monitored in patients being treated with lithium. [2] Therapeutic plasma levels of lithium range from 0.5 to 1.5 mEq/L, with levels of 0.8 or higher being desirable in acute mania. [14] Lithium levels should be above 0.6 mEq/L to reduce both manic and depressive episodes in patients. [15]
Lithium – Lithium is the "classic" mood stabilizer, the first to be approved by the US FDA, and still popular in treatment. Therapeutic drug monitoring is required to ensure lithium levels remain in the therapeutic range: 0.6 to 0.8 or 0.8–1.2 mEq/L (or millimolar).
Lithium carbonate can induce a 1–2 kg of weight gain. [70] In addition to tremors, lithium treatment appears to be a risk factor for development of parkinsonism-like symptoms, although the causal mechanism remains unknown. [71] Most side effects of lithium are dose-dependent. The lowest effective dose is used to limit the risk of side effects.
The extraction of lithium carbonate at high pressures of CO 2 and its precipitation upon depressurizing is the basis of the Quebec process. Lithium carbonate can also be purified by exploiting its diminished solubility in hot water. Thus, heating a saturated aqueous solution causes crystallization of Li 2 CO 3. [20]
Lithium citrate was removed from 7Up in 1948 [5] after the Food and Drug Administration banned its use in soda. [6] Lithium citrate is used as a mood stabilizer and is used to treat mania, hypomania, depression and bipolar disorder. [7] It can be administered orally in the form of a syrup. [7]
In December 2021, the FDA approved lumateperone for the treatment of bipolar depression in adults as monotherapy and as adjunctive therapy with lithium or valproate. [2] [7] The number needed to treat (NNT) for bipolar depression at a dose of 42 mg daily is 7 patients.
Lithium prevents mood relapse and works especially well in BP-II patients who experience rapid-cycling. [53] Almost all BP-II patients who take lithium have a decrease in the amount of time they spend ill and a decrease in mood episodes. [53] Along with medication, other forms of therapy have been shown to be beneficial for BP-II patients.
He then went to New York for eight years to work with Ronald R. Fieve on studies of Bipolar disorder and the emerging Lithium treatment, and developed the concept of 'rapid cycling' for bipolar disorder which was found to show less response to Lithium (he credits Canadian scientist Harvey Stancer for first noticing the connection a year prior).
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