• Type: Antimanic agent
  • Dosage Forms:
  • Routes of Administration: oral
  • Common Trade Names:

Adult Dosing

  • Maintenance: 300mg PO 3 to 4 times daily; desired serum lithium level 0.6 to 1.2 mEq/L
  • Acute manic episode: 600mg PO 3 times daily; desired serum lithium level 1 to 1.5 mEq/L

Pediatric Dosing

Safety/efficacy not established in children <12yo

Special Populations

  • Pregnancy Rating: D
  • Lactation risk: infant risk cannot be ruled out

Renal Dosing

  • Adult: Contraindicated if renal function unstable[1]

Hepatic Dosing

  • Adult: Not established


  • Allergy to class/drug
  • Unstable renal function
  • Severe dehydration
  • Sodium depletion
  • Severe debilitation
  • Concurrent diuretics
  • Severe cardiovascular disease
  • 1st trimester pregnancy

Adverse Reactions


  • Toxicity (see Lithium toxicity)
  • Seizure, ataxia, raised ICP
  • Angioedema
  • Erythema multiforme


  • Hypothyroidism, weight gain
  • Nephrotoxicity
  • Fine tremor, hyperreflexia
  • Leukocytosis
  • Nausea, gastritis
  • Acne


  • Half-life: 14-50hr
  • Metabolism: Renal
  • Excretion: Renal

Mechanism of Action

  • Exact mechanism unclear; inhibits postsynaptic D2 receptor supersensitivity, alters cation transport in nerve cells, influences serotonin/norepinephrine reuptake, inhibits phosphatidylinositol cycle second messenger systems[2]

See Also


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