Quilonum SR

Generic Name: Lithium carbonate
Product Name: Quilonum SR

Indication

Prevention of manic or depressive episodes in bipolar disorder
Treatment of acute mania
Schizoaffective disorder and chronic schizophrenia
Augmentation for treatment-resistant depression

Action

Unknown; actions include inhibition of dopamine release, enhancement of serotonin release and decrease formation of intracellular second messengers. Lithium has little or no psychotropic effect in normal individuals.

Dose advice

Dosage
Maximum: 2500mg daily
Acute mania: Initially 750-1000mg daily. Measure serum concentration for 5-7 days and increase dose by 250-500mg daily (depending on serum concentration) until symptoms resolve. Check serum concentrations 5-7 days after each dose increase
Prophylaxis: 250-1000mg daily for 2 weeks, then adjust dose according to serum concentration
Elderly, renal impairment: use reduced dose and monitor carefully
Concentration Monitoring:
Therapeutic range: Acute mania- 0.5-1.2mmol/L; Prophylaxis- 0.4-1.0mmol/L
Symptoms of toxicity: common > 1.5mmol/L (> 1.2mmol/L in the elderly) Clinical toxicity can occur at lower serum concentrations in some cases, particularly those with organic neurological damage or other CNS illnesses (e.g. epilepsy)
Duration:
Continue maintenance treatment for 6-12 months after first episode of acute mania. Maintain prophylaxis if there is clear evidence for 2 or 3 episodes of either mania or depression in the last few years or if there is rapid cycling. Other factors, such as the severity of episodes and family history, may also suggest a need for ongoing prophylaxis.

Schedule

Common side effects

Metallic taste
Nausea
Diarrhoea
Epigastric discomfort
Weight gain
Fatigue
Headache
Vertigo
Tremor
Acne
Psoriasis
Leukocytosis
Polyuria
Hypothyroidism
Benign T wave changes on ECG