Hey, all Eric Christensen here, pharmacist on the real-life pharmacology podcast.

Hope you guys are enjoying the show, finding it valuable.

Today I'm going to cover lithium pharmacology.

And in all honesty, thinking about the pharmacology and the mechanism of action,

there's still a lot that isn't exactly known about lithium and how exactly it

works. There's proposed mechanisms at this time, alterations in norapinephrine and serotonin

in the brain, but there's lots of potential different activity that lithium could have. However, we do know

that it can help in maintenance treatment as well as acute treatment of bipolar disorder. So if you

remember in bipolar disorder, there's a couple of different forms.

Probably the most classic or memorable one, maybe you'll hear taught about throughout school

or in practice is patients who have manic episodes where it's basically a flight of ideas,

continuous talking, maybe an elevation in the way they're thinking as far as their stature and importance and maybe some ego associated with that manic episode as well.

Lack of sleep can certainly happen during those manic episodes as well. And lithium

can help reduce that and prevent kind of that cycling from depression to mania and back and

forth. So lithium is generally not utilized first line due to the fact that there is a lot

of clinical quirks, drug interactions, potential toxicities that we can run into. And patients can struggle with using this medication due to some of those side effects, which

I'll kind of get into here.

So thinking about lithium, lithium is one of the few drugs.

We do it for a few, I guess, but where we monitor levels.

And lithium levels generally, target range is 0.5 to 1, 0.5 to maybe up to 1.2, kind of depending upon what you're

trying to do and patient response and all different sorts of things like that that may come into play.

With that lithium level, obviously, if we're under that,

...