【藥品性質提示】 根據 2019 AGS Beers Criteria，本藥品為【潛在不適當用藥 (PIM)】，不建議老年人併用ACEI、Loop類利尿劑使用。

Bipolar disorder (maintenance therapy or manic episode)

Antimanic Agent
The precise mechanism of action in mood disorders is unknown. Traditionally thought to alter cation transport across cell membranes in nerve and muscle cells, influence the reuptake of serotonin and/or norepinephrine, and inhibit second messenger systems involving the phosphatidylinositol cycle. May also provide neuroprotective effects by increasing glutamate clearance, inhibiting apoptotic glycogen synthase kinase activity, increasing the levels of antiapoptotic protein Bcl-2 and, enhancing the expression of neurotropic factors, including brain-derived neurotrophic factor.

Distribution:
Vd: 0.7 to 1.4 L/kg
Metabolism:
1. Kidney: almost entirely
2. Elimination Half Life: (General) 14 to 24 hr; (Elderly) 36 hr; (Children) 17.9 hr; (Bipolar patients) up to 2.4 days
Excretion:
1. Renal: 89% to 98%
2. Dialyzable: Yes

1. Hypersensitivity to lithium or any component of the formulation.
2. Severe cardiovascular or renal disease, severe debilitation, dehydration, sodium depletion, concurrent use with diuretics.

D (FDA) (AUS)

It is generally recommended that breastfeeding be avoided during maternal use of lithium; however, treatment may be continued in appropriately selected patients.

Common:
Acne, Hyperparathyroidism, Hypothyroidism, Weight increased, Gastritis, Nausea, Xerostomia, Leukocytosis, T remor, Deep tendon, Nephrotoxicity, Polyuria, Potential sign of toxicity, Increased thirst, Potential sign of toxicity
Serious:
Bradyarrhythmia, Sinus node dysfunction, Transient reduction in peripheral circulation as a whole, Erythema, Ataxia, Coma, Pseudotumor cerebri, Increased intracranial pressure and papilledema, Seizure, Epileptiform, Blurred vision, Tinnitu, Giddiness, Renal interstitial fibrosis, Angioedema

Bipolar disorder, maintenance therapy:
300 mg 3 to 4 times daily; desired serum lithium level 0.6 to 1.2 mEq/L
Bipolar disorder, manic episode:
600 mg 3 times daily; desired serum lithium level 1 to 1.5 mEq/L

Safety and effectiveness in pediatric patients below the age of 12 have not been established

1. CrCl 10 to 50 mL/minute: Administer 50% to 75% of normal dose
2. CrCl <10 mL/minute: Administer 25% to 50% of normal dose
3. ESRD with hemodialysis: Dose after dialysis
4. CRRT: Administer 50% to 75% of normal dose

There are no dosage adjustments provided in manufacturer's labeling.