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Your post was and educational. I agree with you Lithium has been a primary in the treatment of bipolar disorder (BD) for several decades. Despite a general reduction in the use lithium over the past several years, it is effective in the management of both manic and depressive episodes in BD and continues to be recommended as a first-line mood stabilizer. The patient complained of nausea and diarrhea. About 75% of people who take lithium for bipolar disorder have some side effects, although they may be minor. They may become less troublesome after a few weeks as the body adjusts to the drug. Nausea and diarrhea are some of the common side effects of lithium. Nausea may correlate with lithium levels, especially peak levels, therefore educating the patient to taking lithium after meals, using a multiple daily dose regimen, or using sustained release preparations may diminish the symptom. Diarrhea increases in patients through the first 6 months of treatment and it is normally associated with lithium toxicity. In this case with the patient there is no toxicity since the patient just stated the medication and stated that she does not take the medication as prescribed and that she stops taking the medication. I agreed that switch immediate release to lithium to prolonged release lithium. When she has these side effects, she is unable to take the medication. Â Even Though direct studies relative between prolonged-release (PR) versus immediate-release (IR) formulations of lithium. Designs of lithium are mainly limited to pharmacokinetic studies; PR formulation of lithium gives possible advantages over IR formulation and can be efficiently used in the management of BD with reduced adverse events (Girardi et al., 2016).
According to (Gitlin 2016) stated that nausea is seen in about 10-20% patient treated with lithium, and it tends to be more prominent in early stage of the treatment and less common in long-term use of the medication or use sustained release preparations may diminish nausea. Tolerance to the nausea commonly occurs over time, these strategies can
often be discontinued over time with the resumption of once-daily administration of lithium capsules. Also, a Lithium level should have been ordered to know exactly the patient current lithium level to give a clear picture of what the patient lithium level is currently even though she stated that she stopped the medication and have not been taking the medication constantly.
References
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Girardi, P., Brugnoli, R., Manfredi, G., & Sani, G. (2016). Lithium in Bipolar Disorder: Optimizing Therapy Using Prolonged-Release Formulations. Drugs in R&D, 16(4), 293-302. https://doi-org.ezp.waldenulibrary.org/10.1007/s40268-016-0139-7
Gitlin, M. (2016). Lithium side effects and toxicity: prevalence and management strategies.
International journal of bipolar disorders, 4(1), 1-10.
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Please explain in English. Thanks.
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