LITHIUM CARBONATE
Henry C. Stober
 1.   Description
      1.1   Name, Formula, Molecular Weight
      1.2   Appearance, Color, Odor
      1.3   Drug Properties
2.    Physical Properties
      2.1     Infra-red Spectroscopy
      2.2     Raman spectroscopy
      2.3     Atomic Emission and Absorption Spectroscopy
      2.4     Melting Point
      2.5     Thermogravimetric Analysis
      2.6     Dissociation Constant
      2.7     Conductivity
      2.8     Microscopy
      2.9     Index of Refraction
      2.10 Density
      2 . 1 1 Crystal Structure
      2.12 X-Ray Powder Diffraction
      2.13 Polymorphism
      2.14 Solubility
      2.15 Dissolution
3.    Preparation of Lithium Carbonate
4.    Stability
      4.1   Solution
      4.2   Solid State (Light, Thermal, Humidity)
5.    Methods of Analysis
      5.1   Identification Test for Lithium
      5.2   Identification Test for Carbonate
      5.3   Microchemical Test for Lithium
      5.4   Microchemical Test for Carbonate
      5.5   Volumetric Analysis
      5.6   Atomic Emission and Absorption Spectroscopy
      5.7   Other Spectrometric Techniques
      5.8   Conductivity
      5.9   Ion Selective Electrodes
      5.10 Ion Chromatography
 6. Medicinal History
 7. Pharmacology
ANALYTICAL PROFII.ES OF DRUG SUBSTANCES                                        Copyriglit Q 1986
VOLUME 15                                      hy the American Pharmaceutical Association
                                      367   All rights o!' reproduction i i i any form reserved.
368                                            HENRY C.STOBER
                      LITHIUM CARBONATE
 1.   Description
      1.1 Name, Formula, Molecular Weight
          Chemical Name
          Lithium Carbonate
          Nomenclature
          The following nomenclature is used in Chemical
          Abstracts: Carbonic Acid, Dilithium Salt
          [ 554-13-21
           Trademarks
           The following trademarks are listed in the Merck
           Index (1): Camcolit; Candamide; Carbolith;
           Ceglution; Eskalith; Hypnorex; Lithane; Lithobid;
           Lithonate; Lithotabs; Plenur; Priadel; Quilonum
           retard.
           Molecular Formula and Weight (1)
           Li2CO3                   73.89
           C: 16.25%     Li: 18.78%     0: 6 4 . 9 6 %
      1.2 Appearance, Color, Odor
          White, granular, odorless, light alkaline powder
          (1,2) *
      1.3 Drug Properties
          Lithium Carbonate, by virtue of the therapeutic
          properties of lithium, is used for the treatment
          of manic depressive psychoses. The drug is
          listed in the United States Pharmacopea (21, the
          British Pharmacopoeia (3)) and the Modern Drug En-
          cyclopedia (4), as well as Remington's Pharmaceu-
          tical Sciences (5).
 2.   Physical Properties
      2.1 Infra-red Spectroscopy
          The infra-red spectrum of lithium carbonate
          dispersed in KBr is shown in Figure 1 (6).
          Literature sources have demonstrated that the
          infra-red spectrum of lithium carbonate is
          consistent with its known crystal structure ( 7 ,
          8). The infra-red spectrum of lithium carbonate
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370                                               HENRY C.STOBER
               has also been obtained as a film on sodium
               chloride plate and as Vaseline and flurolub
               suspensions ( 7 , 9 ) . A summary of the character-
               istic infra-red bands for lithium carbonate is
               presented in Table I.
                               TABLE I
      Characteristic Infra-red Bands of Lithium Carbonate (7)
  Frequency (cm-l)        Wavelength (p)     Relative Intensity
          2558                 3.91                    W
          2494                 4.01                    W
          1842                 5.43                    W
          1806                 5.54                    W
          1495                 6.69                   vs
          1437                 6.96                   vs
          1088                 9.19                    M
           866                11.55                    S
           846                11.82                    W
           741                13.50                    W
           7 12               14.04                   vw
               The infra-red absorption band at 1088 cm-l can be
               used to uniquely quantitate lithium carbonate in
               the presence of other alkali carbonates ( 1 0 ) .
               The observed frequencies related to the isotopic
               species 6LizC03 and 'Li~C03 have been reported by
               Tarte ( 1 1 ) .
         2.2   Raman Spectroscopy
               The Raman spectra of crystalline and molten
               lithium carbonate have been reported by Brooker
               and co-workers ( 1 2 , 1 3 ) . Major bands are ob-
               served at 1091 and 1459 cm-l.
         2.3 Atomic Emission and Absorption Spectroscopy
             Lithium carbonate can be made to exhibit the
             characteristic emission spectrum of lithium.
             Three typical analytical emission lines are
             obtained for lithium containing aqueous solu-
             tions. These are summarized along with their
             relative intensities in Table I1 ( 1 4 ) .
LITHIUM CARBONATE                                            371
           The line at 670.8 nm is particularly intense and
           imparts a deep red color to an oxidizing flame.
                          TABLE I1
              Lithium Analytical Emission Lines
            Wavelength (nm)   Relative Intensit9
                670.8                     1
                323.3                  235
                610.4                 3600
           +'relative amount of lithium required for 1%
            response
           Typical sources of excitation include
           air-acetylene and nitrous oxide-acetylene flames.
           More recently electrothermal and argon plasma
           excitation techniques have become available.
           Because of its greater sensitivity the line at
           670.8 nm is most often used for the analysis of
           lithium by flame emission spectroscopy, atomic
           absorption spectroscopy and plasma spectros-
           copy (14, 15).
     2.4   Melting Point
           The melting behavior of lithium carbonate has
           been evaluated by DTA using both heating and
           cooling programs. Lithium carbonate has been
           reported by various sources to melt in the
           temperature range of 714O to 733OC (16-25) depend-
           ing on the atmosphere employed (ie. C02 or air)
           and the degree of dissociation of Li2CO3 to Liz0
           and C02 that occurs as the melting point is
           approached (16, 18, 20, 21).
           Typical thermal properties reported in the
           literature for lithium carbonate are summarized
           in Table 111.
372                                              HENRY C. STOBER
                            TABLE I11
              Thermal Properties of Lithium Carbonate
        Melting Point (23)              993OK; 72OOC
        Heat Capacity (23)              23.2 cal/mole /deg
        Specific Heat (24)              0.315 cal/g
        Heat of Fusion (24)             10.7 kcal/mole
       2.5    Thermogravimetric Analysis
              Data obtained for a typical lot of lithium
              carbonate (H2O < 0.5%)- by thermogravimetric
              analysis is presented in Table IV. Under the
              conditions employed the compound is essentially
              weight stable up to 200OC with only water loss.
              Above 200OC a gradual continuing weight loss is
              observed. This behavior is consistant with that
              reported by Machaladze and co-workers (21).
                             TABLE IV
      Lithium Carbonate:   Thermogravimetric Behavior (26)
         TGA (N2 atmosphere)        Perkin-Elmer TGS-1
         Scan rate 10°C/minute
         RT to 90°C            0.11% weight loss
          900 to 200oc         0.08% weight loss
          ZOOo to 45OOC        0.63% weight loss
          above 45OOC          continuing weight loss
        2.6   Dissociation Constant
              The pKa's for the first and second ionization
              steps of the conjugate acid of the carbonate ion
              are reported in the literature to be 6.38 and
              10.25 respectively (27).
LITHIUM CARBONATE                                         373
     2.7   Conductivity
           The relationship between the equivalent conduc-
           tance (4) and the concentration of lithium
           carbonate is typical of a strong electrolyte. A
           plot of& versus JC yields straight line for
           concentrations less than 0.01N. The equivalent
           conductance at infinite dilution (4')for lithium
           carbonate was determined to be 110.2 R/cm2/Eq
           at approximately 25OC, from this plot (6).
     2.8 Microscopy
         USP Lithium Carbonate is a microcrystalline solid
         that is birefringent under crossed polars. The
         solid has been observed to exist as polycrystal-
         line aggregates ranging from approximately 10 to
         85 micrometers in diameter (6).
     2.9 Index of Refraction (ND25)
         The refractive indices of Lithium Carbonate have
         been reported as 1.428, 1.567 and 1.572 (25).
         Lithium Carbonate is biaxial and is optically
         negative.
     2.10 Density
          The density reported for Lithium Carbonate is
          2.11 g/cc 125):
     2.11 Crystal Structure
          The crystal structure of Lithium Carbonate is
          monoclinic w'th unit cel dimensions of a = 8.39
                      k,
          A, b = 5.00 c = 6.21 , and f3 = 114.5+ (28).
          The crystal lattice belongs to the space group
          Cg - C 2/C and there are four lithium carbonate
          mofecules per unit cell (29, 7).
     2.12 X-Ray Powder Diffraction
          Major lines present in the x-ray powder diffrac-
          tion pattern of USP grade lithium carbonate are
          presented in Table V. Strong lines are observed
          at 31.6, 21.4, and 30.6 degrees 28 for copper Ka
          radiation. These values are in good agreement
          with the literature values of 28 = 31.4, 21.0 and
          30.3 [ASTM Data (30)] and 28 = 31.8, 21.3, and
          30.6 [JCPDS Data (3111.
374                                                                HENRY C. STOBER
                T y p i c a l i n s t r u m e n t a l and experimental c o n d i t i o n s
                used t o o b t a i n t h e x-ray powder d i f f r a c t i o n
                p a t t e r n of l i t h i u m carbonate d e p i c t e d i n F i g u r e 2
                (32) a r e p r e s e n t e d below.
                            I n s t r u m e n t a l Conditions
 Spectrometer:                  Diano 8535 D i f f r a c t o m e t e r
 Generator:                     30 KV, 13 mA
 Tube T a r g e t :             cu                                       0
 Radiation:                     Cu, N i F i l t e r e d , Ka = 1.542 A
 Optics :                       lo Beam S l i t , MR S o l l e r S l i t , 0.1'
                                D e t e c t o r S l i t , 3 O Take-Off Angle
 Goniometer:                    Scan Rate: 2 degrees 29/minute
 Detection:                     SPG-10 D e t e c t o r
                                Rate meter 2500 cps f u l l s c a l e
                                P u l s e Height S e l e c t i o n , EL = 0.2V
 Sample
                                                                          -
                                Sample was ground, s i e v e p t E r o u g h a
                                                                              10
 Preparation:                   No. 100 US Standard Sieve, and back-
                                packed i n t o an aluminum sample h o l d e r .
                   X-Ray Powder D i f f r a c t i o n P a t t e r n o f
                         Lithium Carbonate (USP)
                                     MAJOR LINES
             28 Degrees     *                 dJ;J,                       1/10     Hdc
               21.4                        4.15                            84
               23.5                        3.79                            18
               29.5                        3.03                            24
               30.6                        2.92                            81
               31.6                        2.83                           100
               34.1                        2.62                            31
               36.1                        2.49                            19
               36.9                        2.43                            40
               39.7                        2.27                            19
               48.8                        1.87                            15
        f    28 degrees read t o n e a r e s t 0 . 1 degrees 28
                                                              nh
        *k    Interplaner Distance           (1):      d = 2 Sin 8
                  Figure 2:   X-Ray Powder Diffraction Pattern of Lithium Carbonate
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                              19       23   27   31    35   39   43    47   Degrees 28
376                                         HENRY C . STOBER
      +d** RelativeIntensity in percent based on strongest
      signal. Under the experimental conditions employed
      the relative intensities are subject to change due to
      variations in sample handling and particle size and
      are only included as a guide for identifying strong
      lines.
      The Hanawalt indices for lithium carbonate are 2.8lX,
      4.168 and 2.928 (33).
      2.13 Polymorphism
           Recent literature indicates that up to its fusion
           temperature lithium carbonate exists as only one
           crystal form (18). An earlier report in the
           literature indicated the presence of a
           polymorphic transition at 166OC (17).    The
           possibility of lithium carbonate existing as a
           stable c1 and a metastable f3 phase, under atmo-
           spheric conditions, also has been proposed (34).
           It should be noted, however, that in the
           crystalographic sources consulted (30, 31, 33)
           only one form of lithium carbonate is listed,
           implying that other crystalline forms are
           uncommon.
           Impurities present in lithium carbonate may
           account for some of the thermal effects noted.
           In this respect, Reisman reported an anomalous
           transition at -410OC and an additional heat
           effect at 35OOC (18). The later was suspected to
           be due to the presence of Li20. Impurities such
           as Li20, Na2C03 and K2CO3 are known to form
           eutectics with lithium carbonate and may account
           for some of the anamolies observed. The ternary
           eutectic with Na2C03 and K2CO3 melts at 397O (19)
      2.14 Solubility
           The following equilibrium solubility data was
           obtained either experimentally at 37OC (6) or
           from the literature as indicated in Table VI.
LITHIUM CARBONATE                                        377
                        TABLE VI
    Solubility of Lithium Carbonate in Common Solvents
     Solvent              Solubility        Source
                          (g/lOO ml)
    Water, O°C               1.5             (25)
    Water, 37OC              1.0         experimental
    Water, 100°C             0.7             (25)
    0.1N NaOH, 37OC          1.1         experimental
    1.ON NaOH, 37OC          1.7         experimental
    0.05M tris-buffer, 37OC 1.1          experimental
    Ethanol               Insoluble          (25)
    Acetone               Insoluble          (25)
         Lithium carbonate decomposes in strong mineral
         acids to yield carbonic acid, carbon dioxide and
         the conjugate salt. The solubility of lithium
         carbonate in water has been extensively studied
         as a function of temperature and has been ob-
         served to have a negative temperature coefficient
         of solubility; the solubility decreasing signifi-
         cantly with increasing temperature (35, 36). The
         heat of solution of lithium carbonate in water at
         25OC has been reported as -14,800 20.021 kJ mol-'
         (37) *
         When considering the solubility of lithium
         carbonate in aqueous solutions, it should also be
         noted that lithium forms insoluble salts with
         several common anions including phosphate,
         fluoride and the carboxylate anion of the C14
         - C ~ Bfatty acids (25).
         The solubility product of lithium carbonate in
         water at 25OC is 1.7 x      (38) when the concen-
         tration of the lithium and carbonate ions are
         expressed in moles/liter.
    2.15 Dissolution
         The intrinsic dissolution rate of lithium carbon-
         ate in aqueous solutions was reported by Wall and
         co-workers (39) using the rotating disc method.
         They found linear dissolution rate profiles for
378                                         HENRY C. STOBER
          lithium carbonate in water, simulated gastric
          fluid and tris buffer. Dissolution studies in
          simulated intestinal fluid containing phosphate
          were complicated by the precipitation of trilith-
          ium phosphate onto the disc.
          Dissolution rate determinations for various
          experimental and commercial lithium carbonate
          preparations have been reported in the literature
          (40 - 4 4 ) . Ritschel and Parab ( 4 3 ) evaluated
          seven (six conventional and one sustained re-
          lease) lithium carbonate commercial prepara-
          tions. For the conventional preparations they
          found a good correlation between the ENSLIN
          number and t ( 5 min.), t (10 min.) and MRT (mean
          residence time). The ENSLIN number (amount of
          water in mL absorbed by 1 g of powdered sub-
          stance) is a measure of the hydrophilicity, or
          wetting, of the formulation.
          The wetting of pharmaceutical powders, including
          lithium carbonate, has also been evaluated by
          Lerk and co-workers ( 4 5 ) using contact angle
          measurements. The contact angle 8 obtained for
          lithium carbonate by these workers was SO0 indi-
          cating hydrophilicity.
 3.   Preparation of Lithium Carbonate
      Lithium carbonate is primarily prepared from the
      mineral spodumene, LiAlSizOs ( 4 6 ) . Other mineral
      sources of lithium include petalite (LiAlSi4010),
      amblygonite (LiAl[F,OH]PO4) and lepidolite
      (K2Li3A14Si702[0H,F]3).   Spodumene is the most commer-
      cially important o f the lithium ores because of its
      relative abundance and its relatively high lithium
      content (3.757,).
      In the manufacturing process employed by the Lithium
      Corporation ( 4 7 ) spodumene crude ore, which also
      contains such components as mica, quartz and feldspar,
      is crushed to a fine sand. The crushed spodumene is
      separated from the other components by flotation. The
      “purified” spodumene is subjected to intense heat
      (approximately llOO°C) and milled to a fine powder to
      increase its surface area and reactivity. The powdery
LITHIUM CARBONATE                                            379
     spodumene is treated with strong sulfuric acid at
     25OoC to produce lithium sulfate (LiZSO4).  The
     lithium sulfate produced is separated from the residual
     insoluble components of the ore by aqueous dissolution.
     The resulting lithium sulfate solution is reacted with
     sodium carbonate to produce lithium carbonate, which
     remains in solution. Impurities yielding insoluble
     carbonates are precipitated in this step. The lithium
     carbonate solution is further purified by pH adjustment
     and filtration and concentrated by evaporation. Lith-
     ium carbonate is precipitated from the concentrated
     solution by further treatment with sodium carbonate.
     Pharmaceutical grade material is also further processed
     to meet compendia1 and special requirements such as
     particle size and bulk density. The flow chart depicted
     in Scheme I summarizes the process just described.
     Other processes reported to utilize spodumene involve
     treatment with limestone to produce lithium hydroxide
     ( 4 6 ) and direct recovery of lithium carbonate by
     digestion with aqueous sodium carbonate at 200°C ( 4 8 ) .
     The production of lithium carbonate from lithium
     hydroxide has been accomplished using carbonization
     (COz) ( 4 9 ) and treatment with urea (50).
     A procedure for purifying lithium carbonate by suspen-
     sion in boiling water is described in Volume I of
     "Inorganic Synthesis" ( 5 1 ) . The procedure is based on
     the fact that lithium carbonate is less soluble in hot
     water than in cold water, in contrast to the salts
     that are present as impurities. A zone melting
     procedure for producing single crystals of lithium
     carbonate has also been described ( 5 2 ) .
4.   Stability
     4.1   Solution
           The predominant stability problem for lithium
           carbonate in aqueous solutions occurs in acid
           solutions, in which it decomposes to yield the
           lithium salt of the acid, bicarbonate, carbonic
           acid and ultimately, carbon dioxide.
           Solutions of lithium carbonate are also incompat-
           ible with a variety of cations and anions.
380                                                     HENRY C . STOBER
                                   SCHEME I
          Preparation of Lithium Carbonate from Spodumene
      I       Mined
            Spodumene
                                   Crushina   I
                                                  '
                                                         Fine
                                                      Spodumene
      I        Ore                 Milling               Ore
      1
            Powdery
            Spodumene
                 1
                               -
                               I
                                    Sintering
                                    (1lOO"C)
                                      Size
                                    Reduction
                     (250OC)
             Solution                                 Solution
                                                           I
                                                      Lithium
                                                      Carbonate
                                                               Filtration
                                                               Evaporation
                                                               Sodium
                                                                 Carbonate
                                                      Solid
LITHIUM CARBONATE                                            38 I
           Cations such as calcium and barium, whose carbon-
           ate salts are much less soluble than lithium
           carbonate, and anions such as phosphate, that
           form less soluble lithium salts, should be
           excluded from lithium carbonate preparations.
     4.2 Solid State
           Light
                           -
           Pharmaceutical grade lithium carbonate was
           subjected for one week to visible light, whose
           intensity was 600 foot candles (6). No decompo-
           sition as noted by changes in physical appearance
           (color, texture), weight and titrimetric assay
           for carbonate was observed.
           Therma1
           Samples of lithium carbonate were stored in open
           weighing dishes at 25OC and 105OC, respectively,
           for one week (6). A small increase in the
           titrimetric assay for carbonate from 99.4% to
           99.6% was observed for the sample stored at
           105OC. No change in the assay was noted for the
           sample stored at 25OC. No measureable changes in
           weight or physical appearance were observed for
           either sample. This stable behavior for lithium
           carbonate in the solid state is confirmed by the
           literature (16, 17, 21). Accordingly, the lowest
           temperature at which lithium carbonate has been
           reported to begin to dissociate to lithium oxide
           and carbon dioxide is 2OOOC (21). Other workers
           have reported that dissociation occurs only near
           the melting temperature (15, 16).
           Humidity
           Samples of lithium carbonate stored for one week
           at 25OC/85% RH, 35OC/lO% RH and 35OC/85% RH were
           essentially weight stable (6). This is consis-
           tent with the literature (8, l o ) , which indicates
           that lithium carbonate is not very hygroscopic.
5.   Methods of Analysis
     5.1   Identification Test for Lithium (2)
           When lithium carbonate is moistened with hydro-
           chloric acid, it imparts an intense crimson color
           to a non-luminous flame.
382                                           HENRY C. STOBER
      5.2   Identification Test for Carbonate (2)
            Lithium carbonate effervesces upon the addition
            of an acid, yielding a colorless gas, which when
            passed into a solution of calcium hydroxide,
            immediately causes a white precipitate to form.
      5.3   Microchemical Test for Lithium
            The microscopic identification of lithium is
            practical oniy in materials in which lithium is
            present in relatively high concentrations.
            Identification has been achieved by preparation
            of the tri-lithium phosphate salt, which forms
            star-like clumps (53), the pyroantimonate salt,
            which gives hexagons (53) and an orange-brown
            aurate salt (54). In the absence o f other alkali
            metals lithium reacts with zinc uranylacetate to
            yield regularly developed octahedra (55).
      5.4   Microchemical Test for Carbonate
            Absorption of carbonate, evolved upon acidifica-
            tion of a lithium carbonate preparation, by a
            hanging drop of lead acetate, gives rise to
            acicular crystals occurring singly or in irregu-
            lar aggregates. Both bicarbonate and carbonate
            give a positive response under these conditions.
            When added directly, thallus acetate does not
            precipitate with bicarbonate, but forms colorless,
            long, slender needles with carbonate (56).
      5.5   Volumetric Analysis
            Lithium carbonate is analyzed in the USP ( 2 ) , BP
            ( 3 ) and ACS Reagent Chemicals (57) by titration
            of the carbonate anion. Excess strong acid is
            added to a solution of lithium carbonate and the
            residual acid remaining after neutralization is
            back-titrated with sodium hydroxide. Differences
            exist between these methods with respect to the
            indicators used and the emphasis placed on
            expulsion of carbon dioxide after acidification.
            Alternatively, potentiometric end point detection
            can be accomplished using glass and calomel
            electrodes.
LITHIUM CARBONATE                                         383
     5.6   Atomic Emission and Absorption Spectroscopy
           Solutions of lithium carbonate are frequently
           analyzed for lithium using emission techniques
           such as flame photometry, plasma spectroscopy and
           by atomic absorption. The methods typically
           employ analysis at a wavelength of 670.8 nm,
           which is the most sensitive specific lithium line
           (2, 1 4 ) . These techniques are particularly
           effective for the analysis of lithium in dosage
           forms and biological fluids (2, 40, 4 4 , 58). A
           detailed discussion of the analysis of lithium in
           biological fluids and tissues by flame photometry
           and atomic absorption is presented in the text
           "Lithium Research and Therapy" (59).
    5.7    Other Spectrometric Techniques
           Lithium carbonate has been determined
           spectrophotometrically in tablets using the color
           formed upon complexation of lithium with a
           "crowned" dinitrophenylazophenol ether (60). The
           purple color produced is stable and the absor-
           bance of the solution measured at 560 nm is
           linear over the concentration range from 25 to
           250 ppb. Field desorption mass spectrometry
           (FD-MS) in conjunction with a multichannel
           analyzer has proven to be a useful tool for trace
           analysis of lithium (61). The method also allows
           for the determiation of the isotopic distribution
           of the lithium salt analyzed.
    5.8    Conductivity
           Although nonspecific, conductimetric methods have
           been used for the analysis of strong electrolytes
           (62).  The methods tend to be easily automated.
           The technique is comparatively simple and appli-
           cable to the dissolution rate determination of
           dosage forms providing that the other conducting
           components of the formulation are not present in
           significant amounts. It has been used success-
           fully in the authors laboratory for the determi-
           nation of the dissolution rate of lithium
           carbonate sustained release formulations in water
           (63).  Precautions were required against absorp-
           tion of atmospheric Cop. This was accomplished
           by performing the dissolution rate studies with
           the vessels under a steady stream of nitrogen.
384                                         HENRY C. STOBER
      5.9 Ion Selective Electrodes
          Several workers have explored the usefulness of
          ion selective electrodes for the analysis of
          solutions of lithium (64, 65, 66). The elec-
          trodes are limited by comparatively poor Li+/Na+
          selectivity. This deficiency is especially
          apparent in biological fluids where comparatively
          high levels of Na+ are encountered. Using
          elecrodes based on PVC membranes containing ETH
          1810 as a neutral carrier, Metzger and co-workers
          (64) obtained recoveries of lithium in serum to
          within +_lo% over the clinically relevant concen-
          tration range.
      5.10 Ion Chromatography
           Aqueous solutions of lithium carbonate can be
           readily analyzed for lithium by ion
           chromatography. A polystyrene-divinyl benzene
           sulfuric acid cation exchanger in the hydrogen
           form (Waters, IC-PAC-C) and 2 mM nitric acid
           eluent is employed (67). Under these conditions
           lithium at the ppm level is readily separated
           from sodium and potassium at comparable concen-
           trations. The carbonate anion can also be
           determined using a polymethacrylate anion ex-
           changer in the quaternary ammonium ion form
           (Waters, IC-PAC-A).
 6.   Medicinal History (68, 69)
      Lithium, the lightest of the alkali metals, was
      discovered in 1817 by Arfwedson. Its salts were later
      found in the spa waters of Germany and England, where
      it was believed that it was therapeutic in the treat-
      ment o f rheumatoid arthritis and gout. Its use-
      fulness in the treatment of gout was attributed to the
      high solubility of lithium urate. The use of lithium
      as a uricosuric prompted J. F. Cade in Australia to
      give animals a lithium salt to decrease the nephrotox-
      icity of uric acid. He noted that the lithium salt
      produced a calming effect in the animals and proceeded
      to use lithium salts clinically as a sedative. During
      the 1950's and 1960's the clinical use of lithium
LITHIUM CARBONATE                                        385
     salts was intensely investigated in Europe, where it
     became accepted as an effective and safe treatment for
     manic depressive illness.
     Lithium salts were not accepted in the United States
     until 1970. This was due in part to concerns about
     the safety of lithium salts after several deaths were
     reported (1949-50) among patients using large amounts
     of lithium chloride as a salt substitute. Although
     several lithium salts such as the chloride and bromide
     have been used, lithium carbonate is preferred because
     of its relative stability (it is less hygroscopic than
     the halogen salts) and it is less irritating to the
     gastrointenstinal tract.
7.   Pharmacology (69, 70)
     Lithium carbonate is usually administered as 300 mg
     tablets or capsules. Each 300 mg of the carbonate
     contains 8.12 mEq of lithium. The usual daily dose of
     lithium carbonate for prophylactic therapy is 600 mg
     to 1200 mg.
     Lithium is readily absorbed after oral administration
     in the gastrointestinal tract, peaking in the plasma
     within 1 to 3 hours and tends to distribute evenly
     throughout the total body water space. Lithium is not
     bound to plasma proteins. There is some lag in
     penetration into the cerebrospinal fluid, but there is
     no absolute barrier to its entry into the brain.
     Equilibration of lithium between the blood and the
     brain is almost complete within 24 hours.
     The "metabolism" of the lithium ion is almost entirely
     via the kidneys. About half of a single dose of lith-
     ium is excreted in 24 hours. An important feature of
     the renal excretion of lithium is that its rate is not
     typically increased by the administration of most
     diuretics. Increased administration of sodium appears
     to have minimal effect on the normal excretion of
     lithium, while depressed in-vivo levels of sodium fac-
     ilitate lithium retention. These physiological fac-
     tors have important implications for the management of
     lithium intoxication. The therapeutic plasma range
     (0.5 - 1.5 mEq/L) and the toxic plasma levels (>1.6
     mEq/L) are very close and monitoring is performed at
386                                          HENRY C. STOBER
      the onset of therapy. The mechanism of action of
      lithium ion in manic depression is not clearly under-
      stood. Lithium interferes with the action of the
      catecholamines in the brain. This supports the
      popular hypothesis that in mania catecholamines may be
      functionally overactive in the brain. The role played
      by lithium may also be related to competition with
      sodium ions in body sites, such as electrolyte balance
      across cell membranes, including those of the neurons.
 Acknowledgement
 The typing assistance o f Mrs. Frances Ghiazza in the
 preparation of this manuscript is appreciated.
LITHIUM CARBONATE                                            387
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LITHIUM CARBONATE                                           39 1
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