How much do you know about lithium salts

In life, we may find that some people's emotions often change, they are happy for a period of time, 

and they are full of joy and humor every day, which can resonate with those around them; 

But it is also often accompanied by emotional instability, easy to get angry, and can fly into a rage when encountering small things; 

Saying big things, having a lot of ideas, but doing things with a vague start and no end. 

After a period of time, when I see him, I may feel unhappy again, with a gloomy expression, 

worried, unwilling to do anything, have poor sleep, and even have bad thoughts. 

If the above emotional changes repeatedly occur and exceed a certain period of time, 

affecting one's work and life, we may consider the possibility of this friend having "bipolar disorder". 

If seeking outpatient treatment, medication mainly composed of emotional stabilizers may be given.

Today, let's learn about a commonly used mood stabilizer in clinical practice: lithium carbonate.

Get to know lithium salts

Lithium carbonate is the most common mood stabilizer in clinical practice and the preferred drug for treating bipolar disorder. 

It has therapeutic and preventive effects on manic or depressive episodes of bipolar disorder; 

Schizophrenia can also be treated with lithium salts; 

For individuals with schizophrenia accompanied by emotional disorders and agitation, 

it can be used as an adjuvant medication for antipsychotic treatment.

After taking the medication, lithium salt does not bind to proteins in the body. 

It is evenly distributed in all water containing spaces in the body and does not require biotransformation. 

Ultimately, it is excreted through the kidneys.

The toxic dose of lithium salt is close to the therapeutic dose. 

Lithium competes with sodium for reabsorption in the kidneys, and can easily accumulate in the body when there is a lack of sodium or kidney disease. 

Therefore, it is necessary to regularly monitor the blood concentration of lithium salt, 

adjust the dosage of medication based on the blood lithium concentration, and determine whether there is poisoning and the degree of poisoning.

Common causes of lithium poisoning

1. Patients with kidney disease may experience a decrease in renal clearance rate; 

2. Low intake of salt (sodium); 

3. The patient overdosed on self medication; 

4. Taking lithium carbonate without monitoring blood lithium concentration; 

5. Excessive sweating, heavy physical labor or high fever climate, fever, diarrhea, weight loss diet, diuretic treatment, etc. 

can cause a decrease in blood volume, leading to an increase in blood lithium concentration.

Adverse reactions of lithium salts

The adverse reactions of lithium carbonate are related to the concentration of lithium in the blood, 

usually occurring 1-2 weeks after taking the medication, and some occur later. 

According to the time of occurrence of adverse reactions, they can be divided into early, late stage adverse reactions, and signs of poisoning:

1、Early adverse reactions

General weakness, fatigue, drowsiness, drowsiness, involuntary hand tremors, loss of appetite, reluctance to eat (anorexia, nausea, vomiting), 

diarrhea (diarrhea), frequent urination (polyuria), dry mouth, etc.

2、Late adverse reactions

Continuous frequent urination (polyuria), irritability, thirst (restlessness), obesity (weight gain), 

neck enlargement (thyroid enlargement), fine tremors in fingers, etc.

3、Signs of lithium poisoning

Vomiting, diarrhea, significant involuntary shaking of limbs (gross tremors of limbs), drowsiness, dizziness, unclear speech, and coma.

What should I do if I am poisoned with lithium salt?

Stop using lithium salts, administer large amounts of physiological saline 

or hypertonic sodium salts to accelerate lithium excretion, or perform artificial hemodialysis.

What routine checks are generally required when using lithium salts

1、renal function

Before use, a kidney function test should be performed to assess the patient's kidney function 

and serve as a baseline for observing subsequent changes in kidney function; 

In addition, when using lithium carbonate, it is recommended to have kidney function rechecks 1-2 times a year.

2、Regularly check blood lithium concentration

Generally speaking, the blood lithium concentration during the acute phase should be between 0.6 and 1.2 mmol/L. 

Exceeding 1.4 mmol/L can lead to toxic reactions, especially in elderly people and patients with organic diseases.

3、Measure thyroid function

Lithium salts can affect thyroid function, and regular monitoring of thyroid function can prevent symptoms such as hyperthyroidism or hypothyroidism.

Precautions for taking lithium carbonate

1、Lithium carbonate should be taken after meals to reduce irritation to the gastrointestinal tract.

2、Avoiding a low salt diet and regularly drinking diluted salt water can reduce lithium salt accumulation and adverse reactions.

3、During the use of lithium carbonate, it is advisable to avoid drinking beverages containing caffeine such as coffee and tea.

4、Avoid co administration with aminophylline, caffeine, or sodium bicarbonate, 

as these drugs can increase the urinary excretion of lithium carbonate, reduce blood lithium concentration, and have therapeutic effects.

5、Excessive sweating, heavy physical labor, high fever climate, fever, low salt diet, diarrhea, weight loss diet, diuretic treatment, 

and other conditions can all cause the accumulation of lithium in the body, 

leading to an increase in blood lithium concentration and, in severe cases, lithium poisoning. 

Patients and their families should closely observe whether there are clinical manifestations and signs of lithium carbonate poisoning, 

in order to stop medication and seek medical attention in a timely manner.

Disclaimer: This article is only for health education and is not intended for any commercial advertising purposes. 

It does not provide medical advice and cannot replace hospital examinations and treatments. 

If you have any related diseases, please go to a regular medical institution for treatment in a timely manner and follow the doctor's advice!