LITHIUM

Mechanisms of action; in order of importance: 1. Inositol Phosphatase Inhibitor 2. SHORT-TERM Lithium Use = Inhibits Glutamate Reuptake = More Glu in cleft and more NMDA Receptor activation BUT LONG-TERM, CHRONIC Lithium use = Increases Reuptake of Glu = Less Glu in cleft 3. GSK-3 Inhibition = "Of relevance to mood disorders, GSK-3 inhibition increases hippocampal levels of β-catenin, a function implicated in MOOD STABILIZATION..." 4. Inhibits release of DA and NE from presynaptic terminals (but NOT 5-HT) 5. Uncouples G-q Receptor --------------------------------------------------------------------------------------------------------------------------- Also, Lithium isn't really useful for ACUTE Mania b/c it takes a long time to hit therapeutic plasma levels. That's why you always combine it with an Antiseizure drug or Atypical Antipsychotic. But Lithium for MAINTENANCE is effective and can be monotherapy.