Why is this drug prescribed?

Lithonate is used to treat the manic episodes of manic-depressive illness, a condition in which a person's mood swings from depression to excessive excitement. A manic episode may involve some or all of the following symptoms:

Aggressiveness
Elation
Fast, urgent talking
Frenetic physical activity
Grandiose, unrealistic ideas
Hostility
Little need for sleep
Poor judgment

Once the mania subsides, Lithonate treatment may be continued over the long term, at a somewhat lower dosage, to prevent or reduce the intensity of future manic episodes.

Some doctors also prescribe lithium for premenstrual tension, eating disorders such as bulimia, certain movement disorders, and sexual addictions.

Most important fact about this drug

If the Lithonate dosage is too low, you will derive no benefit; if it is too high, you could suffer lithium poisoning. You and your doctor will need to work together to find the correct dosage. Initially, this means frequent blood tests to find out how much of the drug is actually circulating in your bloodstream. As long as you take Lithonate, you will need to watch for side effects. Signs of lithium poisoning include vomiting, unsteady walking, diarrhea, drowsiness, tremor, and weakness. Stop taking the drug and call your doctor if you have any of these symptoms.

How should you take this medication?

To avoid stomach upset, take Lithonate immediately after meals or with food or milk.

Do not change from one brand of lithium to another without consulting your doctor or pharmacist. Take the drug exactly as prescribed.

While taking Lithonate, you should drink 10 to 12 glasses of water or fluid a day. To minimize the risk of harmful side effects, eat a balanced diet that includes some salt and lots of liquids. If you have been sweating a great deal or have had diarrhea, make sure you get extra liquids and salt.

If you develop an infection with a fever, you may need to cut back on your Lithonate dosage or even quit taking it temporarily. While you are ill, keep in close touch with your doctor.

Long-acting forms of lithium, such as Eskalith CR or Lithobid, should be swallowed whole. Do not chew, crush, or break.

--If you miss a dose...

Ask your doctor what to do; requirements vary for each individual. Do not take 2 doses at once.

--Storage instructions...

Store at room temperature.

What side effects may occur?

The possibility of side effects varies with the level of lithium in your bloodstream. If you experience unfamiliar symptoms of any kind, inform your doctor as soon as possible.

• Side effects that may occur when you start taking lithium include:
  Discomfort, frequent urination, hand tremor, mild thirst, nausea

• Other side effects may include:
  Abdominal pain, blackout spells, cavities, changes in taste perception, coma, confusion, dehydration, dizziness, dry hair, dry mouth, fatigue, gas, hair loss, hallucinations, increased salivation, indigestion, involuntary tongue movements, involuntary urination or bowel movements, irregular heartbeat, itching, loss of appetite, low blood pressure, muscle rigidity, muscle twitching, painful joints, poor memory, restlessness, ringing in ears, seizures, sexual dysfunction, skin problems, sleepiness, slowed thinking, slurred speech, startle response, swelling, thinning hair, tightness in chest, vision problems, vomiting, weakness, weight gain, weight loss

Why should this drug not be prescribed?

Although your doctor will be cautious under certain conditions, lithium may be prescribed for anyone.

Special warnings about this medication

Lithonate may affect your judgment or coordination. Do not drive, climb, or perform hazardous tasks until you find out how this drug affects you.

Your doctor will prescribe Lithonate with extra caution if you have a heart or kidney problem, brain or spinal cord disease, or a weak, run-down, or dehydrated condition.

Also make sure your doctor is aware of any medical problems you may have, including diabetes, epilepsy, thyroid problems, Parkinson's disease, and difficulty urinating.

You should be careful in hot weather to avoid activities that cause you to sweat heavily. Also avoid drinking large amounts of coffee, tea, or cola, which can cause dehydration through increased urination. Do not make a major change in your eating habits or go on a weight loss diet without consulting your doctor. The loss of water and salt from your body could lead to lithium poisoning.

Possible food and drug interactions when taking this medication

If Lithonate is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Lithonate with the following:

ACE-inhibitor blood pressure drugs such as Capoten or Vasotec
Acetazolamide (Diamox)
Amphetamines such as Dexedrine
Antidepressant drugs that boost serotonin levels, including Paxil, Prozac, and Zoloft
Anti-inflammatory drugs such as Indocin and Feldene
Bicarbonate of soda
Caffeine (No-Doz)
Calcium-blocking blood pressure drugs such as Calan and Cardizem
Carbamazepine (Tegretol)
Diuretics such as Lasix or HydroDIURIL
Fluoxetine (Prozac)
Iodine-containing preparations such as potassium iodide (Quadrinal)
Major tranquilizers such as Haldol and Thorazine
Methyldopa (Aldomet)
Metronidazole (Flagyl)
Phenytoin (Dilantin)
Sodium bicarbonate
Tetracyclines such as Achromycin V and Sumycin
Theophylline (Theo-Dur, Quibron, others)

Special information if you are pregnant or breastfeeding

The use of Lithonate during pregnancy is usually not recommended because of the possibility that it might cause birth defects. If you are pregnant or plan to become pregnant, inform your doctor immediately.

Lithonate appears in breast milk and is considered potentially harmful to a nursing infant. If this medication is essential to your health, your doctor may advise you to discontinue breastfeeding while you are taking it.

Recommended dosage

ADULTS

The usual dosage is a total of 1,800 milligrams per day. Immediate-release forms are taken in 3 doses per day; long-acting forms are taken twice a day. The usual dose of syrup is 2 teaspoons, taken 3 times a day.

Your doctor will individualize your dosage according to the levels of the drug in your blood. Your blood levels will be checked at least twice a week when the drug is first prescribed and on a regular basis thereafter.

Long-term Control

Dosage will vary from one individual to another, but a total of 900 milligrams to 1,200 milligrams per day is typical. Immediate-release forms are taken in 3 or 4 doses per day; long-acting forms are taken two or three times a day. The usual dose of syrup is 1 teaspoon 3 or 4 times a day.

Blood levels in most cases should be checked every 2 months.

CHILDREN

OLDER ADULTS

Overdosage

Any medication taken in excess can have serious consequences. If you suspect symptoms of an overdose of Lithonate, seek medical attention immediately.

The harmful levels are close to those that will treat your condition. Watch for early signs of overdose, such as diarrhea, drowsiness, lack of coordination, vomiting, and weakness. If you develop any of these signs, stop taking the drug and call your doctor.