I have been on Lithium for 10 years to help with treating Bipolar Disorder. Lithium enters the bloodstream, accomplishes its mysterious mood-stabilizing duties, and then is simply whisked out of the body intact by the kidneys via urine. So with Lithium, it’s all about kidneys. This article originally appeared in The Carlat Psychiatry Report -- an unbiased monthly covering all things psychiatry.Want more, plus easy CME credit?Subscribe today! It helps reduce the severity and frequency of mania. )( . Toxicity can also be caused by taking a slightly higher dose of lithium over time. ), Advantages of doxycycline over other tetracyclines, Signs and Symptoms of Increased Serum Potassium, Causes of Increased Serum Potassium (Hyperkalemia). Lithium, is the most widely used and studied medication for treating bipolar disorder. TCR VERDICT: Lithium Mnemonic: “No ACE in the Hole”. It may also help relieve bipolar depression. This includes every drug in the non-steroidal anti-inflammatory drug category except Aspirin and Clinoril (sulindac). The kidney doesn’t particularly like to see such havoc being played with its fine-tuned homeostatic mechanism, and actively tries to compensate for the loss of Na by retaining it elsewhere. L ethargy / L eucocytosis. Hydrochlorothiazide. But Na is very similar to Lithium (Li), and in snatching back up as much Na as it can, the kidney indiscriminately snatches up a lot of Li, causing an increase of up to 40% in Li levels. ACE inhibitors (eg, lisinopril, enalapril, and captopril). ), Mnemonics. And, just as in hydrochlorothiazide (above), the kidney compensates by conserving Na in other ways, confuses Li for Na, and you get high levels of Li. Angiotensin II (A-II) is a great molecule if you like vasoconstriction, but if your blood pressure is high, you prefer ACE inhibition, which prevents too much A-II from being created. Carlat Publishing provides clear, authoritative, engaging, independent psychiatric education to make you look forward to learning, with the goal of helping you feel smarter, more competent, and more confident in your ability to help your patients become happy. M etallic taste. These medications exhibit behavior as a mood stabilizer and the mechanism is not entirely known. Lithium toxicity happens when the amount of lithium in your blood is too high. Share to Twitter Share to Facebook Share to Pinterest. We receive no corporate funding, which allows a clear-eyed evaluation of all available treatments. These blood pressure medications work by inhibiting ACE (Angiotensin Converting Enzyme), which normally converts Angiotensin I to Angiotensin II. More to the point though, there are several ways for the kidney to get fooled into retaining too much Lithium. Apr 6, 2018 - Explore TAMIKA's board "PSYCH Mnemonics" on Pinterest. Lithium is the most common cause of drug induced nephrogenic diabetes insipidus which is characterized by polyuria, polydipsia, hypernatremia, and low urine osmolality. If you lower A-II, you lower aldosterone, and limit the kidney’s ability to retain Na. Drugs and conditions: when to stop before surgery? As an aside, both dehydration and low sodium diets can increase Lithium levels, by mechanisms similar to those discussed above: in both cases, the kidney’s trying to hold onto sodium. Lithium: Adverse effects Mnemonic: LITHIUM. Dosage & Route ADULTS. Bottom line: With your Lithium-treated patients, remember the big three of Lithium toxicity: NSAIDs, ACE-inhibitors, and Hydrochlorothiazide. 3. Toxicity can occur if you take a large dose of lithium at one time. Physician. I nsipidus [Diabetes insipidus] U rine excess. Lithium Side Effect Mnemonic. Lithium Side Effect Mnemonic. H ypothyroidism. What causes lithium toxicity? May 20, 2010 3,713 2,317 Status. There’s only one common way for Lithium levels to be decreased, and that’s through caffeine intake. So how is all this related to Lithium? Drug Name. Email This BlogThis! This common diuretic treats hypertension by increasing Na (sodium) excretion in the distal tubule of the kidney, leading to increased urination, decreased total body water, and therefore decreased blood pressure. Caffeine increases the glomerular filtration rate, causing us to urinate more, leading to indiscriminate losses of solutes, including Lithium. This condition causes volume depletion, which in turn results in increased lithium reabsorption and subsequent toxicity… T eratogenicity. In patients with mood disorders, such as bipolar disorder and treatment of SIADH this every... Dose of lithium doses is sufficient studied medication for treating bipolar disorder medications exhibit behavior a! 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