Eskalith (Lithium carbonate)

Introduction

Eskalith is a prescription medication that contains the active compound lithium carbonate. It is supplied as a 300 mg oral tablet and belongs to the class of mood stabilizers. Lithium carbonate has been used for decades to treat mood disorders, most notably bipolar disorder. The medication is manufactured by several pharmaceutical companies under various brand names, including Lithobid and Eskalith. In addition to its primary indication for bipolar disorder, lithium has demonstrated efficacy in preventing suicide and may be employed off-label for augmentation of antidepressant therapy or for certain cluster-headache protocols, always under specialist supervision.

What is Eskalith?

• Definition - Eskalith is a lithium carbonate tablet formulated to deliver 300 mg of elemental lithium per dose.
• Classification - It is classified as a mood stabilizer and a psycho-active inorganic salt.
• Development history - Lithium’s psychiatric use was first reported in the 19th century, but modern therapeutic formulations began in the s after controlled trials confirmed its benefit in bipolar disorder.
• Manufacturer - The product is produced by multiple licensed manufacturers worldwide; in the United States it has been marketed by companies such as Allied Pharmaceuticals and Lundbeck under the brand name Lithobid, while the name Eskalith is used in several international markets.

Eskalith is a lithium carbonate tablet; generic lithium carbonate is also widely available and may be offered by our online pharmacy as a cost-effective alternative.

How Eskalith Works

Lithium carbonate’s exact mechanism of action is not fully understood, but several neuro-biological effects have been identified:

1. Modulation of second-messenger systems - Lithium inhibits inositol monophosphatase, reducing the recycling of inositol and thereby dampening overactive phosphatidyl-inositol signaling pathways implicated in mood swings.
2. Neuroprotective influence - It enhances the expression of brain-derived neurotrophic factor (BDNF) and promotes neuronal resilience, which may contribute to its long-term stabilizing effect.
3. GSK-3β inhibition - By blocking glycogen synthase-kinase-3β, lithium influences circadian rhythm regulation and synaptic plasticity, both of which are disrupted in bipolar disorder.

Therapeutically, these actions result in a reduction of manic episodes, prolongation of depressive remission, and overall mood stabilization. Lithium’s onset of clinical effect typically begins within one to two weeks for mania and may require up to six weeks for full antidepressant benefit. The drug’s half-life ranges from 18 to 24 hours, allowing once- or twice-daily dosing once the therapeutic serum concentration (.6-1.2 mmol/L) is achieved.

Conditions Treated with Eskalith

• Bipolar I Disorder (Manic and Mixed Episodes) - Lithium is the gold-standard mood stabilizer for acute mania and for long-term prophylaxis against recurrence.
• Bipolar II Disorder (Depressive Episodes) - Though less robust for pure depression, lithium’s prophylactic effect reduces the frequency of depressive relapses when used continuously.
• Prevention of Suicide and Self-Harm - Large epidemiological studies and meta-analyses have shown that lithium therapy is associated with a statistically significant reduction in suicide rates among patients with mood disorders.

These indications are approved by major regulatory agencies such as the U.S. Food and Drug Administration (FDA) and the European Medicines Agency (EMA). Lithium’s efficacy is linked to maintaining serum levels within the narrow therapeutic window, which necessitates regular blood monitoring.

Off-Label and Investigational Uses of Eskalith

• Augmentation of Antidepressant Therapy - Clinical trials have reported that low-dose lithium (often 300 mg twice daily) can enhance response rates in treatment-resistant major depressive disorder when added to selective serotonin reuptake inhibitors (SSRIs) or tricyclic antidepressants. This use is not FDA-approved and should only be pursued under specialist supervision.
• Cluster Headache Prophylaxis - Small-scale studies suggest lithium may lessen the frequency of chronic cluster headaches, likely through modulation of hypothalamic pathways. Evidence remains limited, and safety monitoring is essential.
• Aggression and Impulse-Control Disorders - In certain forensic or neuropsychiatric populations, lithium has been investigated for its ability to reduce aggression and impulsivity, though data are mixed.

All off-label applications must be discussed with a qualified healthcare provider, and the benefits-risk balance should be carefully evaluated.

Is Eskalith the Right Medication for You?

Suitable patient populations

• Adults diagnosed with bipolar I disorder who require acute mania control or long-term relapse prevention.
• Patients with a history of suicidal ideation or attempts, where lithium’s anti-suicidal properties are deemed advantageous.
• Individuals able to comply with regular serum lithium monitoring and fluid-intake recommendations.

When Eskalith may be less appropriate

• Patients with significant renal impairment (eGFR < 30 mL/min/1.73 m²) or a history of chronic kidney disease.
• Individuals with severe cardiovascular disease, uncontrolled thyroid disorders, or known hypersensitivity to lithium salts.
• Pregnant or breastfeeding women, unless the therapeutic benefit outweighs potential fetal or neonatal risks, as lithium crosses the placenta and appears in breast milk.

A comprehensive medical assessment, including baseline kidney and thyroid function tests, is essential before initiating therapy.

Risks, Side Effects, and Interactions

Common

• Tremor - Fine, postural tremor, often dose-related.
• Polydipsia and Polyuria - Increased thirst and urination due to lithium’s effect on renal concentrating ability.
• Gastro-intestinal discomfort - Nausea, mild abdominal cramps, or loose stools, usually transient.
• Weight gain - Modest increase over months of therapy.

Rare

• Hypothyroidism - Lithium can interfere with thyroid hormone synthesis; periodic TSH monitoring is advised.
• Dermatologic reactions - Rash, acne-like eruptions, or photosensitivity.
• Neurocognitive effects - Subtle memory or concentration difficulties at higher serum levels.

Serious

• Lithium toxicity - Presenting as severe tremor, ataxia, confusion, seizures, or cardiac arrhythmias. Toxicity is more likely with serum concentrations > 1.5 mmol/L, dehydration, or drug interactions.
• Renal impairment - Chronic lithium use may lead to nephrogenic diabetes insipidus or, rarely, interstitial fibrosis.
• Severe hypothyroidism - May manifest as myxedema coma in extreme cases.

Drug-drug interactions

• Non-steroidal anti-inflammatory drugs (NSAIDs) - Reduce renal clearance, raising lithium levels.
• Thiazide diuretics (e.g., hydrochlorothiazide) - Increase lithium reabsorption, precipitating toxicity.
• ACE inhibitors and ARBs - Also diminish lithium excretion.
• Antipsychotics (e.g., clozapine) - May augment neurotoxic risk when combined with high lithium levels.

Drug-food interactions

• Sodium intake - Low dietary sodium can increase lithium reabsorption; maintain consistent sodium consumption.
• Caffeine - May slightly increase lithium clearance, potentially lowering serum concentrations.

Patients should inform their healthcare team of all concurrent medications, supplements, and dietary habits.

Use: Dosing, Missed Dose, Overdose

Standard dosing

• Initial adult dose: 300 mg orally two to three times daily (total 900-120 mg), titrated to achieve a serum lithium concentration of .6-1.2 mmol/L.
• Dose adjustments are guided by serum levels, renal function, and clinical response; maintenance doses often range from 600 mg to 180 mg per day.

Missed dose

• If a dose is missed by less than 12 hours, take it as soon as remembered.
• If more than 12 hours have passed, skip the missed dose and resume the regular schedule. Do not double-dose to compensate.

Overdose management

• Suspected lithium overdose requires immediate medical attention. Symptoms such as severe tremor, vomiting, confusion, or seizures warrant urgent evaluation.
• Treatment may involve gastric lavage, intravenous hydration, and, in severe cases, hemodialysis to rapidly reduce serum lithium concentration.

Practical precautions

• Take tablets with a full glass of water; food does not markedly affect absorption but may improve gastrointestinal tolerance.
• Avoid alcohol, as it can exacerbate central nervous system depression and interfere with lithium’s pharmacokinetics.
• Refrain from operating heavy machinery or driving until you know how Eskalith affects you, especially during dose titration.

FAQ

• What should I do if I need to travel internationally with Eskalith?

  • Carry the medication in its original container with a copy of the prescription and a letter from your clinician if required. Keep it in your carry-on luggage to avoid temperature extremes and check the destination country’s regulations on lithium importation.

• Can I store Eskalith tablets in a humid climate?

  • Store the tablets in a cool, dry place away from direct sunlight. Excess humidity can degrade the tablet coating; using a sealed plastic container with a desiccant packet is advisable.

• Do the tablets have any distinctive markings?

  • Most 300 mg lithium carbonate tablets are round, light-blue or white, and imprinted with “300 mg” or the manufacturer's logo. Appearance may vary by supplier, so verify with the packaging.

• Are there any inactive ingredients that could cause allergies?

  • Common excipients include lactose, cornstarch, and magnesium stearate. Patients with lactose intolerance or specific food allergies should review the full ingredient list provided by the pharmacist.

• How often must I have blood tests while on Eskalith?

  • Serum lithium levels are typically checked every 5-7 days after dose changes, then every 3-6 months once stable. Renal and thyroid function tests are recommended at baseline and semi-annually.

• Is lithium safe for people with high blood pressure?

  • Lithium does not directly affect blood pressure, but some antihypertensive agents (especially diuretics) can raise lithium concentrations. Coordination with your prescriber is required to adjust doses accordingly.

• Can I take over-the-counter sleep aids while on Eskalith?

  • Mild antihistamines (e.g., diphenhydramine) are generally safe, but sedative agents may potentiate lithium-related neuro-cognitive effects. Always consult a pharmacist before combining.

• What is the recommended fluid intake while using Eskalith?

  • Aim for at least 2 L of water per day, unless instructed otherwise by a clinician, to maintain stable lithium levels and reduce the risk of nephrogenic diabetes insipidus.

• Does Eskalith interfere with drug testing for employment?

  • Routine workplace drug screens do not detect lithium. However, specific forensic toxicology panels can identify lithium if explicitly requested.

• Why do some patients experience weight gain on lithium?

  • Lithium may alter metabolism and increase appetite, leading to modest weight gain over months. Lifestyle counseling and regular exercise can mitigate this effect.

Glossary

Therapeutic window

The narrow range of serum drug concentrations in which Eskalith provides clinical benefit without producing unacceptable toxicity. For lithium, this is typically .6-1.2 mmol/L.

Nephrogenic diabetes insipidus

A condition where the kidneys become resistant to antidiuretic hormone, leading to excessive urination and thirst; a known chronic effect of long-term lithium therapy.

Serum lithium concentration

The amount of lithium measured in the blood, expressed in millimoles per liter (mmol/L), used to guide dosing and monitor safety.

GSK-3β inhibition

The suppression of glycogen synthase-kinase-3 beta, an enzyme involved in intracellular signaling; lithium’s inhibition of this enzyme contributes to mood-stabilizing effects.

Buying Eskalith from Our Online Pharmacy

Eskalith can be obtained safely through our online pharmacy. We partner with licensed international suppliers that source the medication directly from manufacturers adhering to strict Good Manufacturing Practice (GMP) standards. This arrangement enables us to offer the drug at prices that closely reflect the manufacturer’s cost, providing a cost-effective alternative to many domestic pharmacies.

All products are quality-verified before dispatch, ensuring each tablet meets established potency and purity specifications. Orders are packaged discreetly and shipped via reliable carriers; typical delivery options include express service (approximately 7 days) or standard airmail (about 3 weeks), with tracking available for every shipment.

Because we operate as a pharmacy broker service, we can reach patients who encounter limited local availability, insurance barriers, or high out-of-pocket expenses. Our process respects patient privacy at every step, employing secure data handling and unobtrusive packaging to protect your confidentiality.

Choosing our online pharmacy means you gain affordable access, assured product integrity, and confidential delivery, helping you stay on your prescribed treatment plan without unnecessary financial or logistical obstacles.

Disclaimer

The information presented about Eskalith is intended for general educational purposes and does not replace personalized medical advice. Treatment decisions-including the use of Eskalith for off-label indications-should be made under the direct oversight of a qualified healthcare professional. Readers are presumed to be responsible adults capable of assessing health information critically. Our online pharmacy provides a means to obtain Eskalith for individuals who may encounter limited access through conventional channels or who seek a more affordable generic option. Always discuss with your clinician before initiating, adjusting, or discontinuing any medication.