Lithium Medications

Lithium is a naturally occurring alkali metal used as a mood stabilizer in bipolar disorder. It helps regulate mood by influencing serotonin and other neurotransmitter systems.

Lithobid

Lithium

$0.60 per pill

300mg

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About Lithium

Lithium, a simple alkali metal administered as lithium carbonate or lithium citrate, has been a cornerstone in the treatment of bipolar disorder for decades. As a mood stabilizer, it reduces the frequency and severity of manic episodes and helps prevent depressive relapses. Commercially, lithium is sold under brand names such as Lithobid, Eskalith, Cibalith-S and Priadel, while generic formulations are widely available. Its primary therapeutic action stems from modulation of intracellular signaling pathways, though the exact mechanism remains partially understood. Beyond bipolar maintenance, clinicians sometimes use lithium off-label to augment antidepressants in treatment-resistant depression. Because lithium’s therapeutic window is narrow, regular monitoring of blood levels, renal function and thyroid status is essential. In Singapore, the Health Sciences Authority (HSA) regulates lithium as a prescription medication, ensuring that products meet stringent quality standards. Below, we explore how lithium works, its approved and off-label uses, dosing considerations, safety profile, and how you can obtain it conveniently through our online pharmacy.

What is Lithium?

Lithium belongs to the class of mood-stabilizing agents used primarily in psychiatry. The Health Sciences Authority of Singapore approved lithium carbonate in the early -s for the maintenance treatment of bipolar disorder, and the U.S. FDA later extended its label to include acute manic episodes. The drug is a simple monovalent cation that exerts its effects by influencing several neuronal pathways, most notably inhibition of inositol monophosphatase and glycogen-synthase-kinase-3 (GSK-3). These actions lead to reduced excitatory neurotransmission and stabilization of mood-regulating circuits. Lithium is marketed both as branded tablets (Lithobid, Eskalith) and as inexpensive generic tablets, all of which are stocked by our pharmacy service.

How Lithium Works

Mechanism of Action

Lithium penetrates neuronal membranes and accumulates intracellularly, where it competitively inhibits the enzyme inositol monophosphatase. This reduces the recycling of phosphatidylinositol-4,5-bisphosphate, dampening the phosphoinositide signaling cascade that is often overactive in mania. Concurrently, lithium blocks GSK-3, a kinase involved in neuroplasticity and circadian rhythm regulation. The combined effect decreases hyper-excitability and promotes neuroprotective processes.

Therapeutic Effects

By attenuating over-active signaling, lithium lowers the risk of manic spikes and mitigates depressive swings. Clinically, patients often experience fewer mood episodes, reduced hospitalizations, and improved functional outcomes. The drug also exerts modest anti-suicidal properties, a benefit highlighted in multiple meta-analyses.

Onset and Duration

Therapeutic effects in acute mania usually become evident within 5-7 days of reaching target serum concentrations (.6-1.2 mmol/L). For long-term mood stabilization, benefits accrue over weeks to months as steady-state levels are maintained. The half-life of lithium ranges from 18 to 24 hours in healthy adults, allowing once- or twice-daily dosing.

Approved Uses and Applications

Approved Indications

Maintenance therapy for bipolar disorder: Prevents recurrence of both manic and depressive episodes (HSA, FDA).
Acute mania: Short-term control of elevated mood, agitation and psychosis (FDA).
Bipolar depression (as adjunct): Used in some jurisdictions for depressive phases when monotherapy is insufficient.

Off-Label Uses

Augmentation of antidepressants in treatment-resistant major depressive disorder. Although not officially approved, several controlled trials reported enhanced response rates when lithium is added to selective serotonin reuptake inhibitors.
Prophylaxis of cluster headaches (rarely employed; limited evidence).
Neuroprotective research in Alzheimer's disease (experimental stage).

Clinical Efficacy

A landmark randomized trial published in The New England Journal of Medicine demonstrated that lithium reduced suicide attempts by 80 % compared with placebo in bipolar patients. The Lancet meta-analysis of 30 studies reported a 30 % lower relapse rate in lithium-treated individuals versus placebo over a two-year follow-up. These data underpin lithium’s status as the gold-standard mood stabilizer.

Buying Lithium from Our Online Pharmacy

Why Choose Our Service

Accessing lithium can be challenging due to supply constraints in some regions. Our online pharmacy bridges that gap, offering discreet, secure delivery to any Singapore address. Prices are transparent, and we provide a Lifetime 10 % discount on all reorders, making long-term therapy more affordable.

Brand Names and Generic Options

Lithobid - branded tablet, 300 mg.
Eskalith - branded extended-release tablet, 450 mg.
Cibalith-S - capsule formulation, 300 mg.
Generic lithium carbonate - tablets ranging from 150 mg to 600 mg, typically 40-50 % cheaper than branded options.

Quality & Safety

We partner with licensed international pharmacies that comply with WHO Good Manufacturing Practice (GMP) standards, ensuring each shipment meets strict potency and purity criteria.

Pricing & Access

Standard generic tablets start at SGD .45 per 300 mg unit, while branded options range from SGD 1.20 to SGD 2.00 per tablet. Bulk purchases receive additional volume discounts, and the Lifetime 10 % discount applies automatically at checkout.

Discreet Delivery

Express delivery arrives within ~7 days, and standard shipping within ~3 weeks. Every package is placed in unmarked, tamper-evident envelopes to protect your privacy.

Dosing, Formulations & Administration

Available Formulations

Lithium is offered as immediate-release tablets (150 mg, 300 mg, 450 mg), extended-release tablets (600 mg), and capsules (300 mg). Liquid formulations are uncommon in Singapore but may be compounded when needed.

Typical Dosing Ranges

Bipolar maintenance: Clinicians often start with 300 mg twice daily, titrating to achieve serum levels of .6-1.2 mmol/L.
Acute mania: Initial doses of 600 mg on the first day, followed by 300 mg twice daily, are common, with adjustments based on blood monitoring.
Adjunctive depression: Lower end-range dosing (150-300 mg twice daily) may be used, again guided by serum concentrations.

Administration Guidelines

Take lithium with a full glass of water, preferably with food to lessen gastrointestinal upset. Consistency in salt intake helps maintain stable serum levels; drastic changes in dietary sodium can alter lithium excretion. Avoid dehydration, as it raises lithium concentrations and heightens toxicity risk.

The exact dose and formulation must be determined by a qualified healthcare professional who can consider renal function, age, weight and concomitant medications.

Safety Profile & Considerations

Common Side Effects

Tremor - reported in >10 % of patients; often dose-related.
Polydipsia and polyuria - increased thirst and urine output, observed in 5-15 % of users.
Gastrointestinal discomfort - nausea, mild diarrhea; usually transient.
Weight gain - modest increase in body weight over months.

Serious Adverse Events

Lithium toxicity - serum levels >1.5 mmol/L can cause confusion, ataxia, seizures, and renal failure; immediate medical attention required.
Nephrotoxicity - chronic use may lead to reduced glomerular filtration rate; periodic kidney function tests are essential.
Hypothyroidism - up to 20 % of long-term users develop elevated TSH; thyroid hormone replacement may be necessary.

Contraindications

Severe renal impairment (eGFR < 30 mL/min/1.73 m²).
Advanced heart block or uncontrolled arrhythmias.
Known hypersensitivity to lithium salts.

Drug Interactions

CYP450 inhibitors (e.g., fluoxetine) can increase lithium levels indirectly via renal clearance changes.
NSAIDs and thiazide diuretics reduce renal excretion, raising serum concentrations.
ACE inhibitors may also augment lithium levels; close monitoring is advised.

Special Populations

Pregnancy: Lithium crosses the placenta; first-trimester exposure carries a small risk of cardiac malformations. Women planning pregnancy should consult obstetric and psychiatric specialists.
Breastfeeding: Small amounts appear in breast milk; infants may be at risk for toxicity.
Elderly: Reduced renal clearance necessitates lower starting doses and more frequent monitoring.
Renal or hepatic impairment: Dose adjustments and tighter serum level checks are mandatory.

Frequently Asked Questions

How does lithium differ from valproate in treating bipolar disorder? Lithium primarily stabilizes mood by modulating intracellular signaling, whereas valproate works as a broad-spectrum anticonvulsant that enhances GABAergic activity. Clinical guidelines often recommend lithium for patients with a strong family history of bipolar disorder or a high risk of suicide, while valproate may be preferred for rapid cycling or mixed states.
How long before lithium produces noticeable effects for acute mania? Therapeutic serum concentrations are usually reached within 5-7 days, and most patients notice a reduction in agitation and racing thoughts by the end of the first week. Full stabilization may take 2-3 weeks as dose titration continues.
What should I do if I experience tremor while taking lithium? Mild tremor is common and often dose-related. Contact your clinician to discuss possible dose reduction, timing adjustments, or adding a β-blocker for symptom control. Do not stop the medication abruptly.
Can I take lithium with food? Yes. Taking lithium with meals can lessen stomach upset and does not significantly affect absorption. Consistency in timing (e.g., always with breakfast) helps maintain stable blood levels.
Are there foods I should avoid while on lithium? Sudden reductions in dietary sodium can increase lithium reabsorption and raise serum levels, raising toxicity risk. Aim for a moderate, consistent salt intake and stay well-hydrated, especially in hot weather.
How often should my blood lithium level be checked? After initiating therapy, levels are typically measured weekly until stable, then every 3-6 months for maintenance. Additional tests are required after dose changes, illness, or when starting interacting medications.
Is lithium safe for long-term use? When monitored regularly, lithium can be used safely for many years. However, clinicians must track kidney and thyroid function at least annually, adjusting therapy as needed.
What are the signs of lithium toxicity I need to watch for? Early symptoms include nausea, vomiting, diarrhea, and coarse tremor. Progression may lead to confusion, slurred speech, ataxia, and seizures. Seek emergency care if any of these develop.
Can lithium be used in combination with other mood stabilizers? Combination therapy is sometimes employed for refractory cases, but it increases the risk of side effects and requires careful serum level monitoring. Always discuss combination strategies with your psychiatrist.
What information should I provide my doctor when discussing lithium?
- Complete list of current medications, including over-the-counter drugs and supplements.
- History of kidney or thyroid disease, or any cardiovascular conditions.
- Recent changes in diet, especially salt and fluid intake.
- Any previous adverse reactions to psychiatric medications.

Disclaimer

The information provided about lithium is for general knowledge only. It does not replace professional medical consultation or the official prescribing information for medications containing this ingredient. All treatment decisions, including dosing, formulation selection, and monitoring, should be made under the supervision of a qualified healthcare provider who can assess individual medical history, current medications, and specific health needs. We assume all readers are responsible adults capable of making informed decisions about their health. Our online pharmacy offers access to medications containing lithium for individuals who may have limited availability through traditional pharmacies, prescription-based insurance schemes, or who are seeking affordable generic alternatives. Always consult your doctor before starting, changing, or discontinuing any medication containing lithium.