Orris

Lithium dose

Reading File
Finding Sources
Searching PubMed

lithium AND dosing

Searching the Web

lithium carbonate prescribing information dosage adult bipolar disorder FDA label

Lithium dosing must be individualized using blood levels, kidney function, age, indication, and other medicines. Do not start, stop, or change it without the prescriber.
For adults with bipolar I disorder, a common lithium carbonate regimen is:
  • Starting dose: 300 mg three times daily.
  • Acute mania: titrate to a 12-hour trough serum lithium concentration of 0.8 to 1.2 mEq/L. This may require about 600 mg two to three times daily.
  • Maintenance: target 0.8 to 1.0 mEq/L, often 300 to 600 mg two to three times daily.
Check the level about 3 days after starting or changing dose, drawn 12 hours after the last dose. The FDA prescribing information also recommends baseline and ongoing renal function, thyroid function, electrolytes, medication-interaction review, and pregnancy assessment.
Extra caution: lower starting doses and closer monitoring are needed with impaired kidney function; lithium is generally avoided with severe renal impairment. Dehydration, low salt intake, vomiting/diarrhea, NSAIDs such as ibuprofen, ACE inhibitors, ARBs, and thiazide diuretics can raise lithium levels.
Seek urgent medical advice for possible toxicity: worsening tremor, marked drowsiness/confusion, unsteady walking, slurred speech, persistent vomiting/diarrhea, or seizures.
If you mean a dose for a particular person, provide the formulation, current dose, reason for use, most recent 12-hour lithium level, kidney function, age, and concurrent medicines.

Anciety disorder and classification

Reading File
Finding Sources
Finding Sources
Searching PubMed

anxiety disorders classification

Searching the Web

DSM-5-TR anxiety disorders diagnostic categories official APA

Reading File

Anxiety disorder

Anxiety is a subjective feeling of uneasiness, fear, dread, or apprehension. It becomes an anxiety disorder when the fear or worry is excessive, persistent, difficult to control, and causes significant distress or impairment in social, occupational, academic, or daily functioning.
Before diagnosing a primary anxiety disorder, consider medical causes such as hyperthyroidism, hypoglycemia, arrhythmias, respiratory illness, substance use or withdrawal, and medication adverse effects. Anxiety may also occur with depression, bipolar disorder, psychosis, and trauma-related disorders. - Harrison’s Principles of Internal Medicine, 22e, p. 3700

DSM-5-TR classification of anxiety disorders

  1. Separation anxiety disorder
    Excessive fear or anxiety about separation from attachment figures. It can occur in children or adults.
  2. Selective mutism
    Consistent inability to speak in specific social situations despite being able to speak in other situations, usually beginning in childhood.
  3. Specific phobia
    Marked fear of a particular object or situation, for example animals, blood/injections, heights, flying, or enclosed spaces.
  4. Social anxiety disorder (social phobia)
    Fear of social situations in which a person may be observed, judged, embarrassed, or negatively evaluated.
  5. Panic disorder
    Recurrent, unexpected panic attacks followed by at least one month of worry about further attacks and/or maladaptive behavioral change. A panic attack may involve palpitations, sweating, tremor, breathlessness, chest discomfort, dizziness, paresthesia, and fear of dying or losing control. - Harrison’s Principles of Internal Medicine, 22e, p. 3701
  6. Agoraphobia
    Fear or avoidance of situations where escape may be difficult or help unavailable if panic-like symptoms occur, such as public transport, crowds, open spaces, enclosed places, or being outside alone.
  7. Generalized anxiety disorder (GAD)
    Excessive, difficult-to-control worry about several events or activities, occurring more days than not for at least 6 months. Common features include restlessness, fatigue, poor concentration, irritability, muscle tension, and sleep disturbance.
  8. Substance/medication-induced anxiety disorder
    Anxiety symptoms caused by intoxication, withdrawal, or a medication, for example stimulants, corticosteroids, thyroid hormone excess, or some bronchodilators.
  9. Anxiety disorder due to another medical condition
    Anxiety directly caused by a medical illness, such as thyrotoxicosis, hypoglycemia, cardiac arrhythmia, or pheochromocytoma.
  10. Other specified anxiety disorder
    Clinically significant anxiety symptoms are present, but full criteria for a named disorder are not met; the clinician states why.
  11. Unspecified anxiety disorder
    Clinically significant anxiety is present but there is insufficient information, or the clinician does not specify the reason full criteria are not met.

Important distinction

In DSM-5-TR, these are separate categories and are not classified within anxiety disorders:
  • Obsessive-compulsive disorder and related disorders
  • Trauma- and stressor-related disorders, including PTSD and acute stress disorder
The APA description of DSM-5-TR explains that DSM provides diagnostic classification, criteria sets, and descriptive text.
This is a shared conversation. Sign in to Orris to start your own chat.