Lithium increases the synthesis and concentration of 5HT and reduces noradrenaline and dopamine activity. It competes with mono- and di-valent cations to affect the postsynaptic receptor protein sites and to alter sodium and potassium channel function.
It does not alter the total sleep time but reduces the number of arousals, increases the duration of stages 3 and 4 NREM sleep, increases REM sleep latency and reduces the duration of REM sleep. It also has a small, but consistent, effect in delaying circadian rhythms. It interacts with hypnotics, such as alcohol, to cause sedation and confusion.
The main indication for lithium is to stabilize the mood in bipolar (manic-depressive) disorders and in mania.
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