Lithium
About Lithium
Lithium is prescribed to treat and prevent manic episodes in people with bipolar disorder. Its primary medical purpose is to stabilize extreme shifts in mood, helping to restore a more balanced emotional state. It is also used to prevent recurrent depressive episodes and manage long-term mental stability.
To achieve the best results, you must take this medication consistently at the exact times prescribed by your doctor. It is typically taken with or after meals to help reduce stomach upset. Additionally, keeping a steady daily intake of salt and water is a crucial lifestyle habit that helps maintain stable medicine levels in your body.
While using Lithium, you may experience common side effects like mild hand tremors, increased thirst, or a mild upset stomach. However, you should consult your doctor immediately if you face serious side effects such as persistent vomiting, slurred speech, or extreme drowsiness. Regular blood tests are required to ensure the medication remains at a safe level.
Talk to your doctor before starting this medicine if you have kidney disease, heart problems, or thyroid issues. You should not take this medicine if you have severe kidney disease, severe heart disease, or if you are suffering from severe dehydration. Your doctor will assess whether this treatment is safe for your health history.
Certain medicines like pain relievers, water pills, and blood pressure drugs can interact with Lithium, raising its levels in your body to unsafe amounts. Drinking alcohol should be avoided as it can increase drowsiness and risk of dehydration. Pregnant, breastfeeding, or elderly individuals must consult their doctor before using this medicine to ensure safety.
Managing bipolar disorder can be challenging, but many people achieve long-term mood stability and lead productive, fulfilling lives with the help of appropriate treatment, regular monitoring, and ongoing support.
Uses of Lithium
Medicinal Benefits
By helping to stabilise mood and reduce emotional extremes, Lithium can significantly improve overall mental well-being and quality of life.
- Stabilises Mood Effectively: Helps reduce the severity of manic and depressive episodes, promoting greater emotional balance.
- Prevents Mood Relapses: Long-term treatment can lower the risk of future mood episodes and reduce the frequency of relapses.
- Improves Daily Functioning: Enhanced mood stability can help improve concentration, productivity, decision-making, and social interactions.
- Supports Healthier Relationships: By reducing mood fluctuations, Lithium can help maintain more consistent communication and interpersonal relationships.
- Reduces Hospitalisation Risk: Ongoing treatment may decrease the likelihood of severe mood episodes that require emergency care or hospital admission.
- Promotes Long-Term Stability: Continuous protection against mood swings allows individuals to plan for the future with greater confidence and maintain a more stable, fulfilling life.
Directions for Use
To get the safest and most effective results from Lithium, follow these step-by-step instructions carefully:
- Take this medicine by mouth exactly as directed by your doctor. It is usually taken daily as directed by your doctor.
- Swallow the tablet or capsule whole with a full glass of water. Do not crush, chew, or break the medication unless your doctor or pharmacist specifically tells you to do so.
- Take your doses at the same times every day to keep a steady amount of the medicine in your body.
- You can take this medication with or immediately after food to help prevent stomach irritation or nausea.
- Drink plenty of water throughout the day to stay well-hydrated, unless your doctor advises otherwise.
Always follow your doctor's exact instructions regarding your dose and schedule. Never change your dose or stop taking this medication suddenly without consulting your healthcare provider first, as doing so can cause your symptoms to return quickly.
Storage
Side Effects of Lithium
Common Side Effects (Usually mild)
- Mild trembling or shaking of the hands
- Feeling more thirsty than usual
- Passing urine more frequently
- Mild nausea, stomach upset, or loss of appetite
- Slight weight gain
- Feeling mild fatigue or drowsiness
Serious Side Effects (Call a doctor right away)
- Severe vomiting, persistent diarrhea, or heavy sweating
- Slurred speech, extreme drowsiness, or severe muscle weakness
- Loss of balance, clumsiness, or difficulty walking
- Blurred vision, ringing in the ears, or muscle twitching
- Swelling of the neck (which may point to a thyroid issue)
- Signs of an allergic reaction, such as skin rash, itching, swelling of the face, lips, or throat, and difficulty breathing
Medicines Containing this Salt
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Drug Warnings
- Attend all scheduled blood tests: Regular blood draws are essential to monitor the levels of Lithium in your system and protect your kidneys and thyroid.
- Watch for signs of dehydration: If you develop a fever, severe diarrhea, or vomiting, contact your doctor immediately, as dehydration can rapidly cause the medicine to build up to toxic levels.
- Check your skin and neck: Keep an eye out for any unusual swelling in your neck (a sign of thyroid changes) or severe skin breakouts, and report them to your doctor.
- Inform all healthcare providers: Ensure all doctors, dentists, and pharmacists you visit know that you are taking Lithium, especially before you start any new prescription or over-the-counter medicine.
- Be careful when driving: This medicine can cause drowsiness or dizziness, especially when you first start taking it. Do not drive or operate machinery until you know how it affects you.
- Monitor changes in mood: Inform your doctor promptly if you notice worsening depression, unusual mood changes, increasing irritability, or any thoughts of self-harm or suicide. Early recognition allows your treatment plan to be adjusted safely.
Drug Interactions
Drug-Drug Interactions
Certain medicines can affect the blood levels of Lithium or increase the risk of serious side effects. Inform your doctor about all medications, supplements, and herbal products you are taking.
- NSAID Pain Relievers (such as ibuprofen or naproxen): These medicines may increase Lithium levels in the blood, raising the risk of toxicity.
- Diuretics (Water Pills): Diuretics can increase Lithium concentrations by causing the body to lose salt and water, which may lead to toxic effects.
- ACE Inhibitors and ARBs: These blood pressure medicines can reduce the kidney's ability to remove Lithium from the body, increasing the risk of harmful accumulation.
- Selective Serotonin Reuptake Inhibitors (SSRIs): Taking Lithium with certain antidepressants may increase the risk of serotonin syndrome, a rare but potentially serious condition.
- Other Mood-Stabilising or Antipsychotic Medicines: Concurrent use may increase the risk of neurological side effects and requires careful monitoring.
Drug-Food Interactions
Dietary habits can significantly influence Lithium levels in the body. Maintaining consistency in your diet is important during treatment.
- High-Sodium or Low-Sodium Foods: Sudden changes in salt intake can alter Lithium levels in the bloodstream. Maintaining a consistent dietary sodium intake is recommended.
- Caffeine: Significant increases or decreases in caffeine consumption from coffee, tea, soft drinks, or energy drinks may affect how quickly Lithium is eliminated from the body.
- Fluid Intake: Inadequate fluid intake or excessive sweating may increase the risk of dehydration and Lithium toxicity. Drink adequate amounts of water unless otherwise directed by your doctor.
Drug-Disease Interactions
Certain medical conditions may affect the safety and effectiveness of Lithium therapy and may require close monitoring.
- Kidney Disease: Since Lithium is primarily removed through the kidneys, impaired kidney function can lead to dangerous drug accumulation and toxicity.
- Heart Disease: Lithium may affect heart rhythm and electrical conduction, requiring caution in patients with existing cardiovascular conditions.
- Thyroid Disorders: Long-term use may reduce thyroid hormone production and increase the risk of hypothyroidism, necessitating regular thyroid function monitoring.
- Dehydration or Low Sodium Levels (Hyponatraemia): Conditions that cause dehydration or sodium depletion can significantly increase the risk of Lithium toxicity.
- Severe Gastrointestinal Illness: Persistent vomiting or diarrhoea can alter fluid and electrolyte balance, increasing the likelihood of toxic Lithium levels.
Drug-Drug Interactions Checker List:
Safety Advice
Alcohol
unsafeYou are recommended to avoid consumption of alcohol with Lithium as it may increase the risk of side effects such as drowsiness, dizziness or difficulty in concentrating.
Pregnancy
unsafeLithium is a Category D pregnancy drug and is not recommended for use during pregnancy as it may cause harm to the unborn baby.
Breast Feeding
unsafeAvoid breastfeeding while taking Lithium as it may be excreted in breast milk and cause adverse effects in the baby.
Driving
unsafeLithium may cause dizziness, drowsiness or other severe adverse effects. Therefore, avoid driving if you feel drowsy or dizzy after taking Lithium.
Liver
safe if prescribedLithium is safe to use in patients with Liver diseases/conditions if prescribed by a doctor.
Kidney
cautionTake Lithium with caution, especially if you have a history of Kidney diseases/conditions. The dose may be adjusted by your doctor as required. Lithium is not recommended for patients with severe kidney problems.
Children
cautionLithium is generally not recommended for children below 12 years. However, Lithium may be used in children above 7 years for treating bipolar I disorder only if prescribed by a doctor.
Habit Forming
Diet & Lifestyle Advise
- Keep your salt intake consistent: Do not suddenly start a low-salt diet or dramatically increase your salt intake. Lower salt intake can cause Lithium levels to rise and increase the risk of toxicity, while a significantly higher salt intake can reduce Lithium levels and make the treatment less effective. Consistency is essential.
- Stay consistently hydrated: Drink a steady, healthy amount of water every day (usually 8 to 12 glasses, unless your doctor advises otherwise). Avoid becoming severely dehydrated from heavy exercise, hot weather, or saunas.
- Limit caffeine intake: Keep your daily intake of coffee, tea, and soda consistent. Sudden changes in caffeine consumption can alter how your body processes this medication.
- Avoid alcohol completely: Alcohol can increase drowsiness, impair judgment, and cause dehydration, which significantly raises the risk of medication side effects.
- Monitor your weight: Since weight gain can sometimes occur with long-term use of this medication, try to eat a balanced diet rich in vegetables, lean proteins, and whole grains, and engage in regular, moderate physical activity.
Special Advise
Regular blood tests are advised every week while taking Lithium to monitor the levels of lithium in blood. When lithium levels are constant, blood tests may be done for every 3 months.
Drink constant amount of water daily and maintain a constant sodium intake as any major changes in these two may alter the levels of lithium in blood.
Patients Concern
Disease/Condition Glossary
Mania: It is a mental condition which causes intense excitement, high energy and delusions (misbeliefs). Mania may occur due to lack of sleep or changes in sleep patterns, high levels of stress and alcohol intake. Seek medical help immediately if you have any self-harming or suicidal thoughts. Bipolar disorder, also called manic depression, is a mental condition associated with extreme mood swings ranging from manic highs to depressive lows. The symptoms of bipolar disorder include mania (high energy and excitability) and depression (loss of interest, hopelessness, low energy). Bipolar disorder involves lifelong treatment.
FAQs
Lithium is used to prevent and treat mood disorders like mania and bipolar disorder. It works by increasing the activity of chemical messengers in the brain, thereby suppressing the excessive and abnormal activity of nerve cells in the brain and helping to stabilize a person’s mood.
No, you are not recommended to take Lithium with fluoxetine or other antidepressants such as paroxetine and sertraline as co-administration of these medicines may increase the risk of a rare and serious condition known as serotonin syndrome. If you experience blurred vision, increased heart rate, hallucination, fits, confusion, muscle stiffness or spasm, vomiting, nausea, diarrhoea, excessive sweating, stomach cramps, fever, shaking or shivering, please consult a doctor immediately. However, before using Lithium with any other medicines, you are advised to contact your doctor.
Lithium is not recommended for hypothyroid (underactive thyroid gland) patients as it may increase the risk of low levels of thyroid hormone. Therefore, if you have hypothyroidism, please inform your doctor before taking Lithium. Also, thyroid levels are checked generally before starting treatment with Lithium so that if the levels are too low, Lithium is not advised.
Yes, Lithium may cause weight gain but it is not necessary for everyone taking Lithium to experience this side effect. However, in order to avoid gaining weight while taking Lithium, you are advised to do regular exercise and avoid high-calorie drinks. Instead take non-alcoholic drinks, herbal tea and lemon water.
It is advised to inform your doctor if you are planning or had weight loss surgery as the dose may be adjusted accordingly based on lithium levels in blood.
Yes, Lithium may cause dehydration especially if you have low sodium levels in the body or consume too much alcohol. However, if you notice dark, strong smelling urine or decrease in urination, it indicates that you are dehydrated and may affect lithium levels in blood. Therefore, you are recommended to drink plenty of fluids while taking Lithium to avoid dehydration.
Lithium may cause side effects such as slurred speech, confusion, mood changes, bloating, or lightheadedness. If these side effects persist or worsen, please consult your doctor.
Lithium takes some time to show improvement in your symptoms but it varies from person to person. This is because each patient reacts differently to particular medication. It may take 1 to 3 weeks or longer for you to see the full effects of Lithium. Continue taking Lithium even if you are not improving and consult your doctor.
Yes, Lithium can cause drowsiness or sleepiness. If you feel dizzy or sleepy, avoid driving or using machines or performing any tasks that require your attention.
Take Lithium with or without food or as advised by the doctor. Swallow it as whole with a glass of water. Do not break, crush or chew it.
Some medicines decrease Lithium levels in blood which means that it will not work well. These include caffeine, theophylline (for asthma), medicines containing sodium bicarbonate, or a special group of diuretics (water tablets) called carbonic anhydrase inhibitors and urea (used to treat skin conditions). Therefore, please inform your doctor about the medicines you are taking before starting Lithium to avoid drug interactions.
Yes, you can drink coffee, but it is highly important to keep your daily caffeine intake consistent. Sudden changes in how much coffee, tea, or soda you drink can alter the levels of the medicine in your blood. If you plan to make major changes to your caffeine habits, talk to your doctor or pharmacist.
No, you should avoid taking NSAID pain relievers like ibuprofen or naproxen while using this medication, as they can rapidly increase the drug's levels in your blood to unsafe amounts. For pain relief, consult your pharmacist or doctor for safer alternatives like acetaminophen.
Regular blood tests are necessary to measure the exact amount of the medicine in your bloodstream. This helps your doctor ensure the dose is high enough to work effectively but low enough to avoid toxicity. These tests also help monitor your kidney and thyroid function over time. Talk to your doctor if you have questions about your blood test schedule.
No, you should never stop taking this medication suddenly, even if you feel completely well. Stopping abruptly can cause your mood swings or manic symptoms to return quickly. If you want to discontinue treatment, talk to your doctor, who will guide you on how to reduce your dose gradually.
This medication can potentially cause harm to an unborn baby, especially when taken during the first trimester. If you are pregnant, planning to become pregnant, or suspect you might be, notify your healthcare provider immediately. Talk to your doctor to weigh the benefits of treatment against the potential risks to the pregnancy.
If you experience severe vomiting, heavy diarrhoea, or any condition that causes significant sweating and dehydration, contact your doctor immediately. Dehydration can quickly cause Lithium levels in your blood to rise to dangerous levels. Do not stop or adjust your dose on your own unless your healthcare provider specifically instructs you to do so.
In some cases, long-term use of this medication can affect how well your kidneys function. This is why your doctor will order regular blood and urine tests to monitor your kidney health throughout your treatment. If any changes are detected, your doctor can adjust your treatment plan. Talk to your doctor to understand how to protect your kidneys.
