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Notes:
Dosage
- Dosages of 600
to 1200 mg/d (or blood levels of 0.4 to 0.8 mmol) have been used to
augment antidepressant response. Thase, 1995:1088 (5)
- Serum lithium
levels do not appear to be correlated with responsiveness of depressive
symptoms to lithium augmentation. de Montigny, 1994:32 (5,6)
- One study
has shown that patients with serum levels of 0.4 mmol had a comparable
response to patients with serum levels of 0.8 mmol. de Montigny,
1994:32 (5,6)
- Thus, an inadequate
response to lithium addition may not be remedied by increased doses,
and may increase the risk of adverse events. de Montigny, 1994:32
(5,6)
Adverse effects
- In general, lithium
augmentation appears to be safe if low doses are used. de Montigny,
1994:33 (2)
- Side effects observed
with lithium concentrations of 0.5 mM to 1 mM include hand tremor, weight
gain, thirst, and increased urine production.
- Concentrations >2 mM are characterized by nausea, fine tremors, diarrhea, ataxia,
confusion, slurred speech; >4 mM can cause coma or death. Atack,
1995:343 (2,3)
- Blood levels,
renal status, and thyroid function should be monitored.
- Cognitive effects.
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