Lithium Carbonate
Treatment of manic episodes of manic-depressive illness. Initiate treatment at 600-900 mg/day in 3 divided doses; increase to 1,200-1,800 mg/day in 3 divided doses to achieve serum lithium concentrations between 0.8 and 1.2 mmol/L. Adjust dose according to clinical response and trough serum level (12 h) after steady state is reached (4-5 days). After the acute manic episode subsides, adjust dose to maintain a level of 0.6-1.0 mmol/L. The average dosage range at this stage is usually 450-1,200 mg/day. If a satisfactory antimanic response is not obtained in 14 days, consider discontinuing
lithium.
Once patients are stabilized on a maintenance dose with a multiple dosing schedule and once stable therapeutic blood levels are reached, consider a once-daily dosage regimen. The total daily dose, when given as a single dose, may be about 5-30% lower than when given in divided doses over the day.
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