Lithium Mnemonic

Use the mnemonic LITHIUM (or LMNOP) to remember the side effects and interactions of lithium:

• L - Lethargy (fatigue, sedation)
• I - Insipidus (diabetes insipidus, excessive thirst/urination)
• T - Tremor (fine hand tremors)
• H - Hypothyroidism (low thyroid function)
• I - Interactions (NSAIDs, diuretics, ACE inhibitors)
• U - Upset stomach (nausea, vomiting, diarrhea)
• M - Muscle weakness

Medications that may interact with lithium (narrow therapeutic index drug):

• NSAIDs : Aspirin, ibuprofen, celecoxib, or diclofenac
• Diuretics : Furosemide or bendroflumethiazide
• ACE inhibitors : Enalapril, lisinopril, or ramipri
• Antipsychotic drugs : Can cause severe symptoms, including brain damage
• Anticonvulsants : Carbamazepine or phenytoin
• Calcium channel blockers (CCBs) ) : Can increase the risk of lithium side effects in your brain and nerves
• Methyldopa (Aldomet) : Might increase the effects and side effects of lithium
• Methylxanthines : Can increase how quickly the body gets rid of lithium
• Muscle relaxants : Lithium might increase how long muscle relaxants work

Key points to remember when taking Lithium:

• Stay hydrated to counteract excessive thirst (polydipsia) due to nephrogenic diabetes insipidus.
• Monitor kidney function, thyroid levels, and lithium blood levels regularly to avoid toxicity.
• Avoid NSAIDs as they can increase the risk of lithium toxicity.
• Be consistent with salt intake, as fluctuations can impact lithium levels.
• Take at bedtime to reduce daytime drowsiness and tremors, helping maintain stable blood levels overnight.

Most serious side effect of lithium is lithium toxicity. Symptoms include nausea, vomiting, tremors, confusion, and in severe cases, seizures and kidney damage. Regular blood monitoring is crucial to avoid toxicity.