Indication of Quilonum SR:
Prevention of manic or depressive episodes in bipolar disorderTreatment of acute maniaSchizoaffective disorder and chronic schizophreniaAugmentation for treatment-resistant depression
Action of Quilonum SR:
Unknown; actions include inhibition of dopamine release, enhancement of serotonin release and decrease formation of intracellular second messengers. Lithium has little or no psychotropic effect in normal individuals.
Dose Advice of Quilonum SR:
DosageMaximum: 2500mg dailyAcute mania: Initially 750-1000mg daily. Measure serum concentration for 5-7 days and increase dose by 250-500mg daily (depending on serum concentration) until symptoms resolve. Check serum concentrations 5-7 days after each dose increaseProphylaxis: 250-1000mg daily for 2 weeks, then adjust dose according to serum concentrationElderly, renal impairment: use reduced dose and monitor carefullyConcentration Monitoring: Therapeutic range: Acute mania- 0.5-12mmol/L; Prophylaxis- 0.4-10mmol/LSymptoms of toxicity: common > 15mmol/L (> 12mmol/L in the elderly) Clinical toxicity can occur at lower serum concentrations in some cases, particularly those with organic neurological damage or other CNS illnesses (e.g. epilepsy)Duration: Continue maintenance treatment for 6-12 months after first episode of acute mania. Maintain prophylaxis if there is clear evidence for 2 or 3 episodes of either mania or depression in the last few years or if there is rapid cycling. Other factors, such as the severity of episodes and family history, may also suggest a need for ongoing prophylaxis.
Schedule of Quilonum SR:
S4
Common side effects of Quilonum SR:
Metallic tasteNauseaDiarrhoeaEpigastric discomfortWeight gainFatigueHeadacheVertigoTremorAcnePsoriasisLeukocytosisPolyuriaHypothyroidismBenign T wave changes on ECG
Uncommon side effects of Quilonum SR:
Nephrogenic diabetes insipidus with polydipsia and polyuriaMemory impairmentHair lossHyperparathyroidism
