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how does lithium work?
permeates Na channels - accumulates intercellularly - inhibits agonist stimulated IP3 formation.
what are some side effects of lithium?
blood levels must be regularly monitored. therapeutic levels are 0.8-1.4 mmolLs. can cause diarrhoea, fatigue, muscle weakness, tremor, polydipsia, polyuria, sedation, slurred speech, thyroid dysfunction. toxicity occurs at >2mmol with confusion, drowsiness, vomiting, ataxia, dizziness and severe tremor. at >2.5 mmol - muscle rigidity, convulsion, circulatory collapse and coma
how do we treat acute mania?
antipsychotics (olanzapine, quetiapine, risperidone). can use valproate or lithium if these drugs have worked to reduce symptoms before. lithium however has a slower effect so can't be used if symptoms are too severe.
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