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Lithium carbonate is an inorganic compound, the lithium salt of carbonate with the formula Li2CO3. This white salt is widely used in the processing of metal oxides and has received attention for the treatment of bipolar disorder. It exists as the rare mineral zabuyelite.
It is on the World Health Organization's List of Essential Medicines, a list of the most important medication needed in a basic health system
Lithium orotate, is a salt of orotic acid and lithium. It is available as the monohydrate, LiC5H3N2O4·H2O. In this compound, lithium is non-covalently bound to an orotate ion, rather than to a carbonate or other ion. It is marketed as a dietary supplement used in small doses to treat certain medical conditions, such as stress, bipolar disorder, depression, suicidal ideations, alcoholism,ADHD, attention deficit disorder, aggression, PTSD, Alzheimer's and to improve memory. Intake of lithium has well documented positive neurological effects, and appears to be effective even in trace amounts.Still, lithium orotate's safety remains in question. There have been numerous case reports of patients requiring medical attention after taking lithium orotate supplements.
Properties
Like related lithium salts, Li2CO3 is an ionic compound. Its solubility in water is low relative to other lithium salts. The isolation of lithium from aqueous extracts of lithium ores capitalizes on this poor solubility. Its apparent solubility increases tenfold under a mild pressure of carbon dioxide; this effect is due to the formation of the metastable bicarbonate:
Li2CO3 + CO2 + H2O → 2 LiHCO3
The extraction of lithium carbonate at high pressures of CO2 and its precipitation upon depressuring is the basis of the Quebec process. Approximately 30,000 tons were produced in 1989. Lithium carbonate, and other carbonates of Group 1, do not decompose readily, unlike other carbonates. Li2CO3 decomposes at temperatures ~1300 C.
Extraction and production
Lithium is extracted from primarily two sources: pegmatite crystals and lithium salt from brine pools. Lithium oxide is typically mixed with a specific ratio of carbonate to produce the industry standard of lithium carbonate. Lithium carbonate and oxygen gas can be made by combining lithium peroxide with carbon dioxide.
Medical uses
In 1843, lithium carbonate was used as a new solvent for stones in the bladder. In 1859, some doctors recommended a therapy with lithium salts for a number of ailments, including gout, urinary calculi, rheumatism, mania, depression, and headache. In 1949, John Cade discovered the anti-manic effects of lithium ions. This finding led lithium, specifically lithium carbonate, to be used to treat mania associated with bipolar disorder.
Lithium carbonate is used to treat mania, the elevated phase of bipolar disorder. Lithium ions interfere with ion transport processes (see “sodium pump”) that relay and amplify messages carried to the cells of the brain. Mania is associated with irregular increases in protein kinase C (PKC) activity within the brain. Lithium carbonate and sodium valproate, another drug traditionally used to treat the disorder, act in the brain by inhibiting PKC’s activity and help to produce other compounds that also inhibit the PKC. Despite these findings, a great deal remains unknown regarding lithium's mood controlling properties.
Some studies have suggested therapeutic benefit of lithium carbonate in certain neuromuscular conditions like amyotrophic lateral sclerosis (ALS) and spinal muscular atrophy. A 2010 controlled trial of lithium carbonate in ALS did not confirm earlier suggestions, finding the compound ineffective and possibly toxic in ALS patients. Other research suggests that low dose Lithium supplementation may protect the brain and encourage the growth of grey matter in the cerebral cortex and prevent and slow the progression of Alzheimer's Disease. The two forms of lithium used for Alzheimer's Disease, however, are lithium aspartate and lithium orotate.
It is very important to have the right amount of lithium in your body. Too much lithium may lead to unwanted effects such as nausea, diarrhea, shaking of the hands, dizziness, twitching, seizures, slurred speech, confusion, or increase in the amount of urine. Tell your doctor immediately if these effects occur.
There is only a small difference between the correct amount of lithium and too much lithium. Therefore, it is important that your doctor monitor you closely during treatment. Keep all medical and laboratory appointments while you are taking lithium.
This medication is used to treat manic-depressive disorder (bipolar disorder). It works to stabilize the mood and reduce extremes in behavior by restoring the balance of certain natural substances (neurotransmitters) in the brain.
Some of the benefits of continued use of this medication include decreasing how often manic episodes occur and decreasing the symptoms of manic episodes such as exaggerated feelings of well-being, feelings that others wish to harm you, irritability, anxiousness, rapid/loud speech, and aggressive/hostile behaviors.
OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.
This medication may also be used to prevent a certain type of headache (cluster headache).
How to use Lithobid
There are different brands of this medication available. They may not have the same effects. Do not change brands without asking your doctor or pharmacist.
Take this medication by mouth as directed by your doctor, usually 2-3 times daily. Take lithium with or immediately after meals to lessen stomach upset. Do not crush or chew this medication. Doing so can release all of the drug at once, increasing the risk of side effects. Also, do not split the tablets unless they have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet without crushing or chewing.
Drink 8 to 12 glasses (8 ounces or 240 milliliters each) of water or other fluid each day, and eat a healthy diet with normal amounts of salt (sodium) as directed by your doctor or dietician while taking this medication. Large changes in the amount of salt in your diet may change your lithium blood levels. Do not change the amount of salt in your diet unless your doctor tells you to do so.
Use this medication regularly to get the most benefit from it. To help you remember, take it at the same times each day. The dosage is based on your medical condition, lithium blood levels, and response to treatment. This medication works best if the amount of the drug in your body is kept at a constant level. Therefore, take this drug at evenly spaced intervals.
This medication must be taken exactly as prescribed. It is important to continue taking lithium even if you feel well. Do not stop taking this drug without consulting your doctor. Some conditions may become worse when this drug is suddenly stopped. Consult your doctor or pharmacist for more details.
Tell your doctor if your condition does not improve or if it worsens. It may take 1 to 3 weeks to notice improvement in your condition.
Drowsiness, dizziness, tiredness, increased thirst, increased frequency of urination, weight gain, and mildly shaking hands (fine tremor) may occur. These should go away as your body adjusts to the medication. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
Tell your doctor right away if you have any serious side effects, including: diarrhea, vomiting, fever, unsteady walk, confusion, slurred speech, blurred vision, severe hand trembling (coarse tremor), vision changes (such as growing blind spot, vision loss), joint swelling/pain, muscle weakness, pain/discoloration of finger/toes, cold hands/feet.
Get medical help right away if you have any very serious side effects, including: severe dizziness, fainting, slow/fast/irregular heartbeat, shortness of breath, seizures.
A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
Before taking lithium, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients (such as propylene glycol), which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: heart disease, kidney disease, urinary problems (such as difficulty urinating), underactive thyroid (hypothyroidism), seizures, Parkinson's disease, leukemia, severe dehydration (severe loss of body water), any infection with high fever, a certain skin disorder (such as psoriasis).
Lithium treatment may infrequently reveal an existing condition that affects the heart rhythm (Brugada syndrome). Brugada syndrome is an inherited, life-threatening heart problem that some people may have without knowing it. It can cause a serious (possibly fatal) abnormal heartbeat and other symptoms (such as severe dizziness, fainting, shortness of breath) that need medical attention right away. Brugada syndrome may cause death suddenly. Before starting lithium treatment, tell your doctor if you have any of the following risk factors: Brugada syndrome, unexplained fainting, family history of certain heart problems (Brugada syndrome, sudden unexplained death before 45 years old).
This drug may make you dizzy or drowsy or cause blurred vision. Do not drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely. Limit alcoholic beverages.
If heavy sweating or severe diarrhea occurs, check with your doctor immediately how to best continue taking lithium. Take care in hot weather or during activities that cause you to sweat heavily, such as during hot baths, saunas, or exercise.
Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).
This medication is not recommended for use during pregnancy. It may harm an unborn baby. Consult your doctor for more details.
Lithium passes into breast milk and may have undesirable effects on a nursing infant. Therefore, breast-feeding is not recommended while using this drug. Consult your doctor before breast-feeding.
Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.
Many drugs besides quetiapine may affect the heart rhythm (QT prolongation), including amiodarone, moxifloxacin, procainamide, quinidine, sotalol, thioridazine, among others.
Other medications can affect the removal of quetiapine from your body, which may affect how quetiapine works. Examples include azole antifungals (such as itraconazole, ketoconazole), rifamycins (such as rifampin), drugs used to treat seizures (such as carbamazepine, phenytoin), among others.
Tell your doctor or pharmacist if you are taking other products that cause drowsiness including alcohol, antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and narcotic pain relievers (such as codeine). Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.
This medication may interfere with certain laboratory tests (including urine tests), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug
If overdose is suspected, contact a poison control center or emergency room Symptoms of overdose may include: severe drowsiness, loss of consciousness.
NOTES:
Do not share this medication with others.
Keep all regular medical and psychiatric appointments. Laboratory and/or medical tests (such as blood sugar, blood pressure, cholesterol levels, eye exams, weight, blood counts) should be performed before you start treatment, periodically to monitor your progress, or to check for side effects. Consult your doctor for more details.
MISSED DOSE:
If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.
STORAGE:
Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.
Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Information last revised July 2013. Copyright(c) 2013 First Databank, Inc.
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