Lithium

Lithium is considered the gold standard for bipolar I disorder, but its role in bipolar II disorder is less certain. The article treats elemental lithium dose as more clinically important than the carrier molecule. Lithium dosing is adjusted to maintain serum levels of 0.6 to 0.8 mmol/L. The lithium regimen starts at 300 mg per day for 1 week and increases to 600 mg per day the following week. Standard pharmaceutical lithium carbonate for bipolar disorder is given at 600–1,600 mg per day. Supplemental lithium is described as being used at 1 to 30 mg of elemental lithium for mood support. Low-dose prescription lithium carbonate at 150 mg is described as sufficient to reduce depression-related symptoms and suicidal ideation without therapeutic-dose risks. Lithium in drinking water is associated with lower regional suicide rates at higher exposure levels. Common lithium side effects include gastrointestinal symptoms, renal function changes, hypothyroidism, weight gain, thirst, tremor, and headache. Lithium has a narrow therapeutic window even though it is considered safe and well tolerated when administered correctly. Therapeutic-dose lithium has well-established anti-suicidal proper…