Jump to content
CrazyBoards.org

lithium carbonate vs lithium citrate


Recommended Posts

Someone suggested to me that there are some differences in side effects- particularly GI problems.

anyone know how these two compare? i think she said one is a slow release and the other isn't. i've only had generic so i don't know anything about this.

aside- do you get ekg's when you are on lithium?

Link to comment
Share on other sites

i've only ever heard of doctors rx'ing carbonate (which is avail in time release by two diff manufacturers as Eskalith and Lithobid, and both versions are available in generic).

i know there can be serious problems with some forms of lithium, and that there's a reason docs use carbonate, but i don't know of anything specific about lithium citrate as being harmful, it may be used and is just less common. all i really know about lithium citrate is that [link=http://en.wikipedia.org/wiki/Lithium_citrate" target="_blank]a long time ago it was in 7-Up soda.[/link]

Link to comment
Share on other sites

Lithium citrate is only available (to my knowledge) as a syrup. It comes in a tasty orange flavor. It is dosed in mEq, not mg, so do not be alarmed if the dosage is different. Some pharmacies label the bottle with "equivalent to 900mg" (or whatever) to avoid confusion, some don't.

Some people report less GI disturbance with it. It is absorbed fairly quickly. When my pregnant cousin was suffering from horrible, horrible morning sickness, they changed her to lithium citrate, because she really can't be off lithium for more than 2-3 days. She was able to absorb/retain it most days.

Lithium carbonate comes as immediate-release capsules and, apparently, tablets. I have only ever seen IR capsules.

It also comes as a controlled release tablet. Lithobid and Eskalith CR are the two brand names I'm familiar with here in the US for controlled release lithium. There are numerous generics. I know that some people are quite passionate about their brand name lithium tabs. Whatever. Find one that works and stick with it. I've been quite happy with Roxane generic CR lithium and with Lithobid... when my pharmacy ran out of Roxane, they subbed in Lithobid, and I've seen no difference in levels or performance. (And I am getting weekly blood levels, so we'd probably see it.

Some people feel that the CR results in less nausea, no difference in diarrhea, and that the IR is more likely to provoke nausea, but less likely to result in diarrhea.

My personal experience is that the IR does make me more nauseated than the CR, but it comes in a handy 150mg cap, useful for dosage adjustments. No bowel problems, so I don't know.

I hope that helps a bit.

Link to comment
Share on other sites

Sorry, I forgot the EKG question.

The answer is that it varies. A screening ECG is recommended (standard in some places). If you are cardiac-interesting in addition to mentally interesting, a screening ECG is standard, and a yearly monitoring ECG is common.

If you have pre-existing sick sinus syndrome or unstable congestive heart failure, lithium is likely not the drug for you.

In the real world in my neighborhood, a screening ECG is standard for those over 50 yo and those who have cardiac disease, and a followup ECG is done on those people so that there is a baseline in case there is a problem. However, it doesn't seem common around here to get a screening ECG on everyone, just the risk groups.

It is nice to have a lithiated baseline ECG if you're in the higher-risk groups, because lithium can cause a variety of non-specific changes on ECG, and a baseline can really cut through the crap very quickly.

Link to comment
Share on other sites

  • 2 years later...
Guest Steven  Wakefield

Lithium Carbonate Versus Lithium Citrate

Lithium Carbonate is in fact the most common. It is contained In most lithium 300mg form be it Extended release or shorter acting. Generally what causes more severe GI disturbances are bothe blood level and metabolic half-life.

Lithobid is the Extended Release form Of carbonate and is available in generic form 300mg tabs. The elimination half life is actually 12-18 hours. For side effects there are differences between carbonate and citrate. Eskalith which is in 450mg tablets extended release is Lithium Citrate. For side effect profiles it is generally easier on the GI tract but will generally leard to flatulance as opposed to diarrhea. Another thing about citrate is that it can cause acne and has a higher incidence of Tremors in the limbs. It also has a more intense tranquilizing effect.

Link to comment
Share on other sites

Lithium Carbonate Versus Lithium Citrate

Lithium Carbonate is in fact the most common. It is contained In most lithium 300mg form be it Extended release or shorter acting. Generally what causes more severe GI disturbances are bothe blood level and metabolic half-life.

Lithobid is the Extended Release form Of carbonate and is available in generic form 300mg tabs. The elimination half life is actually 12-18 hours. For side effects there are differences between carbonate and citrate. Eskalith which is in 450mg tablets extended release is Lithium Citrate. For side effect profiles it is generally easier on the GI tract but will generally leard to flatulance as opposed to diarrhea. Another thing about citrate is that it can cause acne and has a higher incidence of Tremors in the limbs. It also has a more intense tranquilizing effect.

Any salt of lithium can cause the evil acne or tremor. Also, I had some MONSTER SIZE blue and white lithium carbonate IR capsules made by APOTEX that contained 600mg each when I was inpatient. It hurt to swallow!

My question, is how difficult is it to switch from IR to CR? Is the dosing guesswork?

Link to comment
Share on other sites

Archived

This topic is now archived and is closed to further replies.

×
×
  • Create New...