Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Lithium is used for the treatment of
manic/depressive (bipolar) and
depressive disorders. Lithium is a positively
charged element or particle that is similar to sodium and potassium. It
interferes at several places inside cells and on the cell surface with other
positively charged atoms such as sodium, potassium, calcium, and magnesium which
are important in many cellular functions.
Lithium interferes with the production and uptake of chemical messengers by
which nerves communicate with each other (neurotransmitters). Lithium also
affects the concentrations of tryptophan and serotonin in the brain. In
addition, lithium increases the production of white blood cells in the bone
marrow. Lithium's effects usually begin within 1 week of starting treatment,
and the full effect is seen by 2 to 3 weeks.
Lithium has been used since the 1950's. The FDA approved lithium carbonate,
the most common preparation, in 1970.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 300, and 450mg. Capsules: 150, 300, and 600 mg.
Syrup: 300 mg/5 ml
STORAGE: Tablets and capsules should be kept at room temperature,
15-30°C (59-86°F).
PRESCRIBED FOR: Lithium is used for treating manic episodes due to
bipolar disorder (manic-depressive illness). It is also combined with
antidepressants to treat depression.
DOSING: Doses vary widely and are adjusted based on measurements of
the levels of lithium in the blood. Recommended blood levels are 06-1.2 mEq/L.
Early in therapy, dose adjustments are made as often as every 5 to 7 days to
establish the correct dose. Most patients require 900-1200 mg daily in 2-3
divided doses. Patients with kidney diseases excrete less lithium from the body
and, therefore, require lower doses.
DRUG INTERACTIONS:Non-steroidal anti-inflammatory drugs
(NSAIDs), [for example, ibuprofen (Motrin, Advil), naproxen Naprosyn, Aleve), indomethacin
(Indocin), nabumetone (Relafen), diclofenac (Voltaren, Cataflam, Arthrotec),
ketorolac (Toradol)], reduce the kidney's ability to eliminate lithium and lead
to elevated levels of lithium in the blood and lithium side effects. Blood
concentrations of lithium may need to be measured for 4 to 7 days after an NSAID
is either added or stopped during lithium therapy.
Aspirin and sulindac
(Clinoril) do not appear to affect lithium concentrations in the blood.
Diuretics (water pills) should be used cautiously in patients receiving
lithium. Diuretics that act at the distal renal tubule, [for example,
hydrochlorothiazide (Hydrodiuril), spironolactone (Aldactone),
triamterene (Dyrenium; Dyazide,
Maxzide)], can increase blood concentrations of lithium. Diuretics that act at
the proximal tubule, [for example,
acetazolamide (Diamox)], are more likely to reduce
blood concentrations of lithium. Diuretics such as furosemide (Lasix) and
bumetanide (Bumex) may have no affect on lithium concentrations in blood.
ACE inhibitors, [for
example, enalapril (Vasotec), lisinopril (Zestril, Prinivil),
benazepril (Lotensin), quinapril (Accupril),
moexipril (Univasc), captopril
(Capoten), ramipril (Altace)], may increase the risk of developing lithium
toxicity, by increasing the amount of lithium that is reabsorbed in the tubules
of the kidney and thereby reducing the excretion of lithium.
Acne is a localized skin inflammation as a result of overactivity of oil glands at the
base of hair follicles. This inflammation, depending on its location, can take the form
of a superficial pustule (contains pus), a pimple, a deeper cyst, congested pores, whiteheads, or blackheads. Treatments vary depending on the severity of the acne.
Depression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. The principal types of depression are major depression, dysthymia, and bipolar disease (also called manic-depressive disease).
Post-traumatic stress disorder (PTSD), a psychiatric condition, can develop after any catastrophic life event. Symptoms include nightmares, flashbacks, sweating, rapid heart rate, detachment, amnesia, sleep problems, irritability, and exaggerated startle response. Treatment may involve psychotherapy, group support, and medication.
Suicide is the process of intentionally ending one's own life. Approximately 1 million people worldwide commit suicide each year, and 10 million to 20 million attempt suicide annually.
Bipolar disorder (or manic depression) is a mental illness characterized by depression, mania, and severe mood swings. Treatment may incorporate mood stabilizer medications, antidepressants, and psychotherapy.
Huntington's disease is the result of degeneration of neurons in areas of the brain. Huntington's disease is an inherited disorder. Early symptoms include mood swings, apathy, depression, and anger uncharacteristic of the individual. Judgement, memory, and other cognitive functions may become impaired. Presymptomatic testing is available for individuals who have a family history of Huntington's disease. Treatment includes medication and therapy for symptoms.
Diabetes insipidus is a condition in which the patient has frequent urination. Symptoms of diabetes insipidus include irritable, listless, fever, vomiting, or diarrhea due to the loss of large volumes of urine. There are three types of diabetes insipidus, central, nephrogenic, dipsogenic, and gestational. Treatment depends upon the type of diabetes insipidus.
Fragile X syndrome is the most common inherited form of mental retardation. It's caused by a mutation on the X chromosome. People with Fragile X syndrome suffer from physical, social, emotional, speech, language, sensory, intelligence, and learning impairments. There is no definitive treatment for Fragile X, though there are ways to minimize the symptoms.
Schizoaffective disorder is a mental illness that features schizophrenia and a mood disorder, either major depression or bipolar disorder. Symptoms include agitation, suicidal thoughts, little need for sleep, delusions, hallucinations, and poor motivation. Treatment may involve psychotherapy, medication, skills training, or hospitalization.
Compulsive gambling is a disorder that affects millions in the U.S. Symptoms and signs include a preoccupation with gambling, lying to family or loved ones to hide gambling, committing crimes to finance gambling, and risking importance relationships and employment due to gambling. Treatment may incorporate participation in Gamblers' Anonymous, psychotherapy, and medications like carbamazepine, topiramate, lithium, naltrexone, antidepressants, clomipramine, and fluvoxamine.
Postpartum depression is a form of depression that occurs within a year after delivery. It is thought that rapid hormone changes after childbirth may lead to depression. Symptoms of postpartum depression include crying a lot, headaches, chest pains, eating too little or too much, sleeping too little or too much, withdrawal from friends and family, and feeling irritable, sad, hopeless, worthless, guilty, and overwhelmed. Treatment typically involves talk therapy and medication.
The term cluster headache is a type of headache that recurs over a period of time. There are episodes that last one to three times a day during a period of time, which may last from 2 weeks to 3 months. There are three main types of treatment abortive medications, preventive medications, or surgery which involves blocking the trigeminal nerve.
Bipolar disorder, or manic-depressive illness, is a disorder that causes unusual and extreme mood changes. Symptoms of bipolar disorder in children and teens include having trouble concentrating, behaving in risky ways and losing interest in activities they once enjoyed. Treatment for bipolar disorder in children and teenagers incorporates psychotherapy and medications.
Taking prescription medications or over-the-counter drugs or supplements should be discussed with your doctor. There are some medications that have been found to cause no problems in pregnancy, however, medications such as Accutane for acne, should never be taken during pregnancy.
Kleine-Levin syndrome is a rare sleep condition, primarily affecting adolescent males. Symptoms of Kleine-Levin syndrome include recurring but reversible periods "episodes" of excessive sleep. There is no definitive treatment for Kleine-Levin syndrome. Medication can be prescribed to treat sleepiness and episodes.
Bipolar disorder, also called manic depression, is a mental illness that is characterized by severe mood swings, repeated episodes of depression, and at least one episode of mania. Bipolar disorder is one kind of mood disorder that afflicts more than
1% of adults in the United States, up to as many as 4 million people. Here are
some additional statistics about bipolar disorder:
Bipolar disorder is the fifth leading cause of disability worldwide.
Bipolar disorder is the ninth leading cause of years lost to death or disability worldwide.
The number of individuals with bipolar disorder who commit suicide is 60 times higher than that of the general population.
People who have bipolar disorder are at a higher risk of also suffering from substance abuse and other mental health problems.
Males may develop bipolar disorder earlier in life compared to females.
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