Talk:Lithium
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| Summary sheet: Lithium |
Lithium salts, or lithium (sold as many salts of the lithium ion and under many trade names, such as Eskalith, Lithobid, and Carbolith) is a widely-prescribed mood-stabilizing pharmaceutical that produces mood-stabilizing, emotional dampening, and anti-manic effects when administered. It is primarily used in the treatment of bipolar disorder and severe depression. Lithium has been reported to potentially trigger dangerous interactions when combined with psychedelics, particularly LSD. History and culture Lithium's mood-stabilizing properties were first discovered in 1949 by John Cade, an Australian psychiatrist. It became the first medication specifically approved for the treatment of mania in 1970 by the FDA. Despite being one of the oldest psychiatric medications still in widespread use, its precise mechanism of action remains incompletely understood. Chemistry Lithium is typically administered as a salt, most commonly lithium carbonate (Li₂CO₃) or lithium citrate. The therapeutic effects come from the lithium ion (Li⁺). Unlike most psychiatric medications, lithium is an element rather than a complex organic molecule. The therapeutic window of lithium is narrow, requiring regular blood monitoring to maintain safe and effective levels, typically between 0.6 and 1.2 mEq/L. Pharmacology Lithium's mechanism of action is complex and multifaceted, including: • Inhibition of inositol monophosphatase and inositol polyphosphate 1-phosphatase • Inhibition of glycogen synthase kinase-3 (GSK-3) • Modulation of neurotransmitter systems including serotonin and dopamine • Effects on circadian rhythms • Neuroprotective effects through various pathways Subjective effects The effects of lithium develop gradually over weeks. Common subjective effects include: Positive • Mood stabilization • Reduction in manic symptoms • Decreased suicidal ideation • Emotional regulation Neutral • Emotional dampening • Reduced emotional reactivity • Mild cognitive dulling Negative • Thirst • Frequent urination • Mild tremor • Reduced creativity (reported by some users) • Weight gain Toxicity and harm potential Risk factors • Narrow therapeutic window • Regular blood monitoring required • Kidney function must be monitored • Dehydration risk • Thyroid function impacts Lethal dosage The lethal dose is approximately 5-10 grams for most lithium salts, though toxicity can occur at lower doses. Symptoms of toxicity include: • Severe tremor • Confusion • Seizures • Kidney failure • Coma • Death Dangerous interactions Psychedelics - Particularly dangerous with LSD, with reports of seizures and psychotic episodes. Combination should be avoided. SSRIs - May increase risk of serotonin syndrome. NSAIDs - Can increase lithium levels to toxic range. Diuretics - Can dangerously alter lithium levels. Legal status Lithium is a prescription-only medication in most countries. It is not scheduled under international drug control conventions. References [Include standard references]