Description
Sedalit Pharmacodynamics
Normotimic agent (normalizes the mental state without causing general lethargy), also has antidepressant, sedative and antimanic effects. The effect is due to lithium ions (Li+), which, being antagonists of sodium ions (Na+), displaces them from cells and thus reduces the bioelectrical activity of brain neurons. Accelerates the breakdown of biogenic amines (decreases the content of norepinephrine and serotonin in brain tissue). Increases sensitivity of hippocampal neurons and other brain regions to the action of dopamine. It interacts with lipids formed during inositol metabolism.
In therapeutic concentrations it blocks the activity of inosyl-1-phosphatase and reduces the concentration of neuronal inositol, which plays a role in the regulation of neuronal sensitivity.
The beneficial effect of lithium drugs in migraine may be associated with changes in serotonin concentrations; in depression with increased serotoninergic activity and decreased regulation of beta-adrenoreceptor function.
Indications
Manic and hypomanic states of various genesis, affective psychoses (manic-depressive, schizoaffective), alcoholism (affective disorders), migraine, Meniere’s syndrome, sexual disorders, drug addiction (some forms).
Contraindications
Hypersensitivity to lithium and other drug components; major surgical interventions; leukemia; pregnancy, breastfeeding; children under 12 years of age (efficacy and safety of use not established); cardiovascular diseases associated with heart rhythm disorders; presence of Brugada syndrome/family history of Brugada syndrome; severe renal failure; untreated or uncompensated hypothyroidism; low sodium levels, such as in patients with dehydration
Dosage and administration
- Orally (3 to 4 doses, last time – before bedtime), after meal, initial dose – 0.6 – 0.9 g/day with subsequent increase to 1.2 g/day, then the dose is increased daily by 0.3 g until a daily dose of 1.5 – 2.1 mg; maximum daily dose – 2.4 g. During therapy selection, plasma Li+ ion concentrations should not be less than 0.6 and not more than 1.2 -1.6 mmol/l. In doses exceeding 2 g/day, treatment duration is 1 – 2 weeks.
- After manic symptoms have disappeared, the daily dose is gradually reduced to a prophylactic dose (0.6-1.2 g). If after dose reduction signs of mania reappear, the dose is increased.
- In acute manic state the therapeutic concentration of Li+ ions in blood should be 0.8 – 1.2 mmol/l, in maintenance treatment – 0.4 – 0.8 mmol/l; if Li+ ion concentration exceeds 1.2 mmol/l, the daily dose should be reduced.
- Positive results of prophylactic monotherapy are seen when maintaining stable blood concentrations in adults within 0.4 – 0.8 mmol/l for at least 6 months, in children – at a dose that allows to maintain therapeutic concentrations within 0.5 – 1 mmol/l.
