Although lithium is commonly used today for the treatment of bipolar disorder, toxicity remains an issue. These toxic effects can be classified into acute, chronic, and acute-on-chronic toxicities, with the latter presenting with mixed findings of both acute and chronic toxicity. Lithium increases serotonin release and receptor sensitivity as well as inhibiting release of dopamine and norepinephrine.
There are multiple hypotheses thought to contribute to these effects. Another proposed mechanism is the inositol depletion hypothesis, in which lithium is thought to deplete myoinositol and reduce phosphoinositide signaling in brain cells, leading to altered gene transcription.
The Link Between Lithium and Weight Gain
Finally, lithium is also hypothesized to decrease CNS arachidonic acid, opposing a signaling pathway thought to be hyperactive in bipolar disorder. Acute Lithium Toxicity Patients with acute lithium toxicity typically present with a history of deliberate ingestion and do not have the already elevated body stores associated with chronic toxicity. Most frequently, acute ingestions result in GI symptoms such as nausea, vomiting, and diarrhea, at times with significant volume loss. Because of this, systemic and neurologic findings manifest late in acute lithium toxicity.
Chronic Lithium Toxicity Chronic lithium toxicity is seen in patients who are already on long-term therapy. These patients typically already have adequate body stores present, but changes in absorption or elimination lead to lithium levels above the narrow therapeutic window and subsequent toxicity.
Lithium (medication)
Lithium is excreted exclusively by the kidneys. Common examples of such drugs include:.
Despite the fact that lithium has been used in the United States for the treatment of treat bipolar disorder since , the mechanisms that provoke weight gain in some people remain unclear. Several theories have been proposed. These processes may work alone or in combination to cause weight gain in people on lithium therapy.
Early weight gain after starting lithium therapy could represent regaining pounds that were previously lost unintentionally. This situation might apply if you experienced a manic episode—which can lead to weight loss due to disinterest in eating and increased activity—before starting lithium. Lithium often triggers increased thirstiness. Quenching your thirst with high-calorie beverages, such as full-calorie soda or fruit juice, is a possible contributor to weight gain.
Lithium: medicine to control mood disorders such as mania and bipolar disorder - NHS
Lithium might also cause sodium and water retention in people who consume a high-salt diet, which can lead to added bodyweight. This condition leads to a reduced metabolic rate, which in turn leads to weight gain. Women taking lithium are significantly more likely to develop hypothyroidism than are men, as reported in a review article published in by the Thyroid Research.
Other hormones and brain signaling chemicals that affect hunger, blood sugar regulation, and fat and energy storage might play a role in lithium-related weight gain. As these processes are very complex and regulated at multiple levels in the body, additional research is needed to determine the possible influence of lithium. Contact your doctor right away if you develop any signs or symptoms that might suggest an underactive thyroid gland such as:. We understand your concern about gaining weight while on lithium therapy.
Before Using
Weight gain is understandably distressing both in terms of your self-image , and your physical and mental well-being. Dealing with racing thoughts? For a diagnosis, the syndrome requires the absence of prior symptoms and persistence of symptoms for greater than 2 months after cessation of lithium.
Lithium is readily absorbed from the gastrointestinal tract. Since lithium is almost exclusively excreted by the kidneys , people with preexisting chronic kidney disease are at high risk of developing lithium intoxication. There are several drug interactions with lithium. Interactions can occur from typical antipsychotics or atypical antipsyhcotics.
In particular, certain drugs enhance lithium levels by increasing renal re-absorption at the proximal tubule.
These drugs are angiotensin-converting enzyme inhibitors , non-steroidal anti-inflammatory drugs and thiazide diuretics. The diagnosis is generally based on symptoms and supported by a lithium level blood level. If the person's lithium toxicity is mild or moderate, lithium dosage is reduced or stopped entirely. If the toxicity is severe, lithium may need to be removed from the body.
The removal of lithium is done in a hospital emergency department. It may involve:. People may be sent home once their lithium level is less than 1. From Wikipedia, the free encyclopedia. Lithium toxicity Other names Lithium overdose, lithium poisoning A bottle of lithium capsules Specialty Toxicology Symptoms Tremor, increased reflexes, trouble walking, kidney problems, altered level of consciousness [1] Complications Serotonin syndrome , brain damage [1] Types Acute, chronic, acute on chronic [1] Causes Excessive intake, decreased excretion [1] Risk factors Dehydration, low sodium diet, kidney problems [1] Diagnostic method Based on symptoms and a lithium level [1] [2] Treatment Gastric lavage , whole bowel irrigation , hemodialysis [1] Prognosis Low risk of death [3] Lithium toxicity , also known as lithium overdose , is the condition of having too much lithium.
StatPearls Publishing. Retrieved 22 December Journal of Intensive Care Medicine. Toxicological Reviews. Place of publication not identified: McGraw Hill Medical.