And I don’t mean the Nirvana song.  (Though I’ve put it on just for this occasion.)

Lithium comes up a lot because it is still widely prescribed and doesn’t act quite like the rest of the drugs in the mood stabilizer and antimanic categories.

Lithium is an alkaline metal ion.  They turn it into a salt for consumption.  It got bit in the 1950s as a treatment for gout, but then they started using it for *everything*.

It is unique in the effects it has on the brain, as it has been found to have a ‘neuroprotective’ effect.  Lithium causes a specific neurochemical to stick around that stimulates nerve growth.  I found this interesting because severe stress has the opposite effect.

Lithium takes 5 days to build up in the body.  They do blood tests because you need to get to between 0.4 and 1.0 because less is not effective, and more has side effects.  Beyond 1.5 you are at risk of toxicity.

When taking Lithium you must stay hydrated.  Lithium in essence is fulfilling the Na (table salt) role in the body.  So dehydration is dangerous because you risk the buildup on Lithium in the system instead of it being flushed out naturally.

We’ll talk more about tremors when we talk about the other drugs, but when it comes to Lithium, fine tremors (fast, small ones) in the hands are quite common, but coarse tremors (slow and more pronounced) can be a sign of toxicity and need to be looked out for.