Mood stabiliser
Lithium carbonate
Brand names: Priadel, Camcolit, Liskonum
Adult dose
Dose: Initial 400mg PO at night (200mg in elderly), titrated to plasma level. Plasma target 0.4–1.0 mmol/L (most patients), narrow therapeutic window
Route: PO
Frequency: OD nocte
Clinical pearls
- Bipolar disorder (acute mania, prophylaxis), augmentation in resistant depression
- Brand-specific prescribing — formulations not interchangeable
- Monitor levels every 3 months when stable; check 12h post-dose
- Patient information booklet, alert card, 24h record book mandatory (NPSA alert)
Contraindications
- Severe renal impairment
- Untreated hypothyroidism
- Cardiac disease (caution)
- Addison's
- Dehydration
- Low-sodium diet
Side effects
- Tremor
- Nephrogenic diabetes insipidus / nephropathy (long-term)
- Hypothyroidism
- Hyperparathyroidism / hypercalcaemia
- Weight gain
- Cognitive blunting
- ECG changes
- Toxicity (>1.5 mmol/L): coarse tremor, ataxia, confusion, seizures, arrhythmia
Interactions
- NSAIDs (avoid — toxicity)
- ACEi/ARB
- Diuretics
- Carbamazepine
- Metronidazole
- Calcium-channel blockers
Monitoring
- Plasma lithium 12h post-dose; week 1, then weekly until stable
- U&E, eGFR, calcium, TFTs at baseline and every 6 months
- ECG
Reference: BNF; NICE CG185; NPSA Patient Safety Alert; https://bnf.nice.org.uk/drugs/lithium-carbonate/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
Pathways
Same specialty