Mood stabilizer
Modulates neurotransmitter signaling and intracellular second messenger pathways, including inhibition of inositol monophosphatase and glycogen synthase kinase-3, stabilizing mood and reducing mania and depression
Bipolar disorder (acute mania and maintenance)
Postpartum psychosis, cluster headache prophylaxis, augmentation in treatment-resistant major depressive disorder (MDD)
Oral immediate-release and extended-release tablets/capsules
300 mg p.o. 1–2 times daily, titrated based on serum lithium levels and clinical response
Serum levels 0.6–1.2 mEq/L (individualized)
Renally excreted unchanged; half-life ~24 hours; steady state reached in 5 days
Tremor, polyuria, polydipsia, nausea, weight gain, cognitive dulling, acne
Nephrotoxicity, hypothyroidism, lithium toxicity, arrhythmias
Monitor serum lithium levels, renal function (creatinine), thyroid function (TSH), and electrolytes every 3–6 months or more frequently with dose changes or clinical status changes
Narrow therapeutic index; risk of toxicity and overdose
Lithium should be used cautiously in patients at risk for dehydration or with renal impairment due to potential nephrotoxicity. Regular kidney function monitoring is essential. Long-term use may impact thyroid function, necessitating routine screening. Lithium may help reduce agitation in dementia and impulsivity in traumatic brain injury (TBI), but risks such as falls and toxicity require close monitoring.