Table 3 Lithium drug–drug interactions
Pharmacokinetics | |
|---|---|
Increase lithium concentrations | |
Angiotensin-converting enzyme (ACE) inhibitors | |
Angiotensin-II receptor antagonists | |
Diuretics: thiazides, spironolactone, furosemide | |
Non-steroidal anti-inflammatory drugs (NSAIDs) | |
Other: metronidazole, baclofen, cotrimoxazole, aciclovir, prostaglandin-synthetase inhibitors tetracyclines, topiramate | |
Decrease lithium concentrations | |
Sodium bicarbonate and sodium chloride containing products | |
Xanthines: theophylline, caffeine | |
Other: urea, mannitol, acetazolamide | |
Pharmachodynamic (Neurotoxicity) | |
Antipsychotics (FGA and SGA) | Tremor, extrapyramidal symptoms, myoclonus Confusion, disorientation, lethargy, NMS Supersensitivity (Tardive Diskinesia, rebound psychosis) |
SSRIs, sumatriptan, | Tremors, dizziness, agitation, confusion, or diarrhea Serotonin syndrome |
Calcium channel blockers | Ataxia, confusion and somnolence, reversible after discontinuation of the medicine |
Carbamazepine, phenytoin | Dizziness, somnolence, confusion, cerebellar symptoms |
Methyldopa | Confusion, disorientation and hand tremors |
Neuromuscular blocking agents | Lithium may prolong the effects of these agents |
Electro Convulsive Therapy | Delirium |