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Mood stabiliser

Lithium Carbonate

Brand names: Priadel, Camcolit

Lithium is a mood stabiliser used in bipolar disorder (treatment and prevention) and as augmentation in resistant depression; it has a narrow therapeutic range.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

• Recommended starting dosage for adults and pediatric patients over 30 kg ( 2.2 ): • Capsules: 300 mg, three times daily • Recommended starting dosage for pediatric patients 20 to 30 kg ( 2.2 ): • Capsules: 300 mg twice daily • Obtain serum lithium concentration assay after 3 days, drawn 12 hours after the last oral dose and regularly until patient is stabilized. • Acute Manic or Mixed Episodes (patients 7 years and older): Titrate to serum lithium concentrations 0.8 to 1.2 mEq/L ( 2.2 ). • Maintenance Treatment for Bipolar I Disorder (patients 7 years and older): Titrate to serum lithium concentrations 0.8 to 1 mEq/L ( 2.2 ). • Pre-treatment Screening: Evaluate renal function, vital …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2026-04-27. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

Its mood-stabilising mechanism is not fully defined; it modulates several intracellular signalling pathways (including inositol monophosphatase).

Prescribing in practice

  • It has a narrow therapeutic index — measure plasma levels regularly (about 12 hours post-dose), and toxicity (coarse tremor, vomiting, diarrhoea, ataxia, confusion, seizures) can be life-threatening.
  • Dehydration, NSAIDs, ACE inhibitors/ARBs, diuretics and renal impairment raise levels — counsel on fluids and interacting drugs.
  • It affects the thyroid and kidneys (monitor) and is teratogenic (cardiac defects); brands are not interchangeable.

Monitoring

Monitor lithium levels regularly (and after any dose, formulation or interacting-drug change), plus renal and thyroid function and calcium periodically.

Counselling the patient

  • Keep to a steady fluid and salt intake, and seek advice if you become dehydrated, vomit or have diarrhoea.
  • Avoid over-the-counter anti-inflammatories (such as ibuprofen) unless advised.
  • Report tremor, vomiting, unsteadiness or confusion, and attend your blood tests; stay on the same brand.

Evidence & guidelines

A first-line long-term treatment in bipolar disorder (NICE CG185), requiring level and organ monitoring because of its narrow margin.

Reference: NICE NG185 Bipolar; NICE NG66 Prescribing Lithium; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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