patient is on lithum 600 mg since 2 years no symptom occured after following with lithium --- is it advisable?

Question

bipolar disorder \\ mania followed by depression when an unexpected happening occured -- doing phone calls ,irritability sleepless nights excentric behaviour at the time of problem and after taking the following prescriptio like lithum 600 mg / valporicsodum (Enchronate chrono) 500 mg she will recover in 7 days and after the recovery phase only on Lithum @ 600 mg as maintanance dose no issue as such - what will happen if we use Lithum for years as maintainanace dose any side effects ,the patient is above average BP and Daibatic and on medication for the two problems --- whether the problem which she aquired from her mother can be extended to her children which are 18 male and girl 9 no symptoms reported in off springs till date adwise

Answer 1

If there is no side effects notice, you can take Lithium even after 2 years till advised by your physician. Read further for information-

What are the common side effects? Many people get no side effects at all. The list here is to tell you what occasionally happens to some people. Because lithium is very similar to sodium (a “salt”), taking lithium is like taking small salt tablets: it makes you thirsty. If you don’t drink more water than usual, you can have dry mouth. But when you do drink more, you will also urinate more. During the day this is usually not a problem, but some people have to get up at night to urinate when they did not need to before. Most people taking lithium will notice these effects somewhat, more so at higher doses.
Some people can have nausea from lithium. The slow-release versions (Lithobid, Eskalith) are much less likely to cause this but can cost you more (not generic). After you have been taking lithium without nausea, becoming nauseous is a dangerous sign: your level may have become too high; get a lithium level if this does not get better, or if you get other lithium side effects. As the dose and blood level go up, some other side effects can occur. Tremor (usually seen as shaky hands) is common. It can often be controlled with low doses of “propanolol”, a blood pressure medication, if you and your doctor decide to continue lithium at this dose. Weight gain can occur with lithium. At first almost everyone will gain a few pounds as their body hangs on to more water (salt effect). Some people can continue to gain weight, though. This is much less of a problem with lithium than with valproate, both in how often it happens and how much weight is gained. Usually at this point we will switch medications, but some people can control the weight issue with regular exercise, wise eating, and avoiding alcohol entirely -- all good health habits anyway. Some people can have “edema”, when your body has too much water, which shows up as ankle swelling or feeling “bloated”. High doses can cause dry skin. At higher doses, loose stool or even diarrhea are frequently noted. Most of the other side effects you will see reported are uncommon. Too high a dose causes nausea, feeling very unsteady or “wobbly”, slurring of speech, and confusion. If you notice these, call the on-call physician (she or he may arrange for a lithium blood test, and may lower your dose until the test shows what to do). It is dangerous to continue lithium if you have these side effects.-

Answer 2

It is different for every patient. Some patients trial without lithium. Weighing up the possible side-effects with medication to complications without medication is the usual way of determining if it is advisable. Serious side effects do not usually occur until you reach a Li blood level of >10mg