Bhausaheb B. Jankar, Devesh D. Gosavi


This study aims to review Lithium-associated ADRs during the treatment and its management. Databases of "Medline", "Google Scholar" and "PubMed" were searched with keywords for studies on ADRs of Lithium. All studies involving safety, monitoring and management of adverse drug reactions of Lithium were included. Most of the studies have reported that up to 50 to 80% of patients develop ADRs on Lithium. Common initial ADRs that develops within 1 w to 6 w are polydipsia and polyuria taken together (50 to 70%) followed by tremors (30 to 60%). GI symptoms (upset, abdominal pain and diarrhoea) up to 30% are other commoner ADRs of Lithium therapy and they mostly disappear later. Weight gain (20 to 50%), Hypothyroidism (14-34%) and Nephrotic diabetes insipidus develop during the long term Lithium therapy. Most of the ADRs are produced even at therapeutic range (0.6–1.2 mEq/l). As serum level increase, i.e. above 1.5 mEq/l, other serious ADRs like muscle fasciculation’s, worsening of tremor, dysarthria, ataxia, EPS, hallucination, and visual disturbances, seizures, coma, and death may be expected. Management of ADRs includes TDM, Dose reduction of Lithium, drugs like diuretics, beta blockers, SR preparations and sometimes withdrawal of the drug. We are concluded that Lithium can cause many ADRs depending upon dose and duration of therapy, hence, the Therapeutic Drug Monitoring of Lithium is necessary.


Lithium, ADR, Bipolar disorder, TDM

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