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Bipolar Disorder: Managing Mania

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Treatments for Mania in Bipolar Disorder

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Lithium continued...

The dose of lithium that patients need varies among individuals and as phases of their illness change. Although bipolar disorder is often treated with more than one medicine, some people can control their condition with lithium alone.

Risks and Side Effects: About 75% of people who take lithium have some side effects, although they may be minor. They may become less troublesome after a few weeks as your body adjusts to the drug. Sometimes, side effects can be relieved by tweaking the dose of lithium. Never change your dose or drug schedule on your own. Do not change brands of this medication without checking with your doctor or pharmacist first. If you are having any problems, talk to your doctor about your options.

Common side effects of lithium can include:

  • Weight gain
  • Impaired memory
  • Poor concentration
  • Mental slowness
  • Hand tremor (Particularly bothersome tremors can be treated with additional medication)
  • Drowsiness or tiredness
  • Hair loss
  • Acne
  • Excessive thirst
  • Increased urination
  • Decreased thyroid function (which can be treated with thyroid hormone)
  • Decreased kidney function

You should notify your doctor if you experience persistent symptoms from lithium or if you develop diarrhea, vomiting, fever, unsteady walking, fainting, confusion, slurred speech, or rapid heart rate.

Be sure to tell your doctor about any history of cancer, heart disease, kidney disease, epilepsy, and allergies. And make sure your doctor knows about all other drugs you are taking. Do not avoid products that contain sodium or are "low sodium," since low dietary intake of sodium can cause the body to retain too much lithium and make lithium blood levels too high.  While taking lithium, use caution when driving or using machinery and limit alcoholic beverages.

If you miss a dose, take it as soon as you remember it -- unless the next scheduled dose is within two hours (or six hours for slow-release forms). If so, skip the missed dose and resume your usual dosing schedule. Do not "double-up" the dose to catch up.

There are a few serious risks to consider. Lithium may cause weakened bones in children, although it's rare.  Lithium also can rarely (1 in 1000 to 1 in 2000 cases) cause a particular type of heart valve birth defect and therefore its use in pregnancy is determined on a case-by-case basis. Breastfeeding isn't recommended if you are taking lithium. People on high blood pressure drugs called diuretics, especially thiazide diuretics, need to be extra careful because dangerous levels of lithium can build up in the blood. Also, in a very few people, long-term lithium treatment can interfere with kidney function.

 

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