The medication lithium is primarily used as a mood stabilizer in certain mental illnesses. Lithium is an anti-manic drug that helps combat symptoms of mood disorders, including mania, hypomania, and depression. As a drug, lithium is most commonly a treatment for bipolar disorder, but it can also help with schizophrenia and limit certain aggressive or self-harming behaviors. Certain features of this drug make it different from other medications and are important to know, if you or a loved one are considering taking it.
Understanding Lithium
You may also recognize lithium as a chemical element that naturally exists in the environment and our bodies. In a medical context, what we refer to as “lithium” is not the pure element but rather various compounds with high levels of the element. These are available in tablet and liquid forms. Some tablets are slow-release medications that you swallow whole with water, so they can break down slowly in your body throughout the day.
Lithium has been a proven treatment for certain mental illnesses and mood disorders for many years. Its ability to decrease atypical activity in the brain is more than proven. So, the drug grants you more control over your emotions and helps you to cope with mood swings, manic periods, and depression symptoms. Despite being able to measure the effects, experts are still not entirely sure how lithium works—though there are some strong theories.
Uses and Benefits
Generally, the main purpose of lithium as a medication is to reduce symptoms of bipolar disorder. Specifically, it limits mania, which is a period involving over-the-top levels of activity, energy, mood, or behavior. Some people experience a less severe form of mania called hypomania that lithium treats as well.
Outside of bipolar disorder, individuals who have severe depression that doesn’t respond to other medications may benefit from lithium therapy. Studies have shown that lithium not only reduces the behavioral changes of states like mania but can also reduce thoughts of self-harm or suicide.
Doctors have also used lithium to treat schizophrenia, a condition that causes atypical thinking and behaviors, as well as a loss of interest in life and strong emotions. Experts will usually only rely on lithium in these cases after antipsychotic drugs have failed.
There have also been cases where lithium has been able to treat disorders of impulse control, certain psychiatric issues in children, anemia, and hyperthyroidism.
Lithium is extremely effective and is one of our best options for treating acute episodes of mania or mixed episodes in people with bipolar disorder. One of its biggest strengths is that it is non-habit-forming and non-addictive.
Risks and Side Effects
Though lithium is an effective medication, it is not without its downsides.
A key issue with lithium medications is that they take a long time to begin working. Some people may have to take lithium for several weeks—or even months—before noticing an effect. Because of this, doctors may begin patients on a combination of drugs while waiting for the lithium to impact symptoms.
Certain symptoms are far more common when first starting lithium therapy. Usually, these symptoms subside after the first few doses, though they can persist. Nausea is the most common, along with frequent urination, hand tremors, and mild thirst.
It is possible to receive too much lithium and develop lithium toxicity. Some early signs of this include diarrhea, loss of appetite, vomiting, drowsiness, muscular weakness, and coordination difficulties. At higher lithium levels, a person may have blurred vision, dizziness, ringing in the ears, and diluted urine. Because lithium therapy is a long-term treatment typically involving a monitoring physician, extreme lithium toxicity is relatively rare.
Should toxicity occur, a doctor will temporarily discontinue doses for up to 48 hours and then resume at a lower dosage.
Precautions and Considerations
Before beginning lithium therapy, it may be worth considering a few factors that could affect your treatment path.
It is important to remember that though lithium side effects may seem scary or dangerous, the drug itself is one of our best ways to manage mental health conditions like bipolar disorder. A doctor wouldn’t prescribe lithium unless they thought it would help improve your day-to-day life.
That being said, lithium is not a drug that you can simply quit taking. If you are in a volatile period of your life or live in an area where your access to medical care is not secure, lithium may not be the ideal choice. Should you need to stop taking lithium for any reason, a doctor will help you slowly reduce your doses to limit side effects.
When taking lithium, you may need to drink more fluids than you typically would. Talk to your doctor to find an appropriate amount to take with this medication.
Lithium drugs are also not suitable for people with severe cardiovascular or renal issues, who are frail, or who have low levels of sodium. It also is not typically used for children under the age of 12.
These medications can also interact poorly with other medications, such as diuretics, ACE inhibitors, and NSAIDs. You should also not take any herbal medications or supplements or over-the-counter remedies without talking with your physician first. Many of these items influence blood levels of lithium.
Lithium therapy also has a complex relationship with pregnancy. The drug can cause fetal harm, so it’s not typically prescribed during pregnancy. However, the benefits of reducing mood disorder symptoms can sometimes outweigh the potential risks.
Because lithium can be slow to have an effect and it’s common to have some initial side effects, some people get burned out and refuse to continue treatment. It’s important to give the medication a chance to work so it can improve your daily life.
Dosage and Administration
Lithium is available in both tablet and fluid forms and in different doses. It is important to stay on track with the doses, or the drug may lose its effect.
If you are taking slow-release capsules, remember to swallow them whole with fluid. You will probably take these medications two to three times a day, preferably with food. Taking lithium with food seems to help limit the gastrointestinal side effects.
You will typically take standard tablets a bit more frequently—usually three to four times a day.
People who have trouble swallowing tablets may take the liquid form instead.
Limit how much caffeine you drink while taking lithium and make sure to drink plenty of fluids.
If you forget a dose, take it as soon as you remember it. Do not double up on doses, so skip a dose if it’s too close to another one. Continue your dosing schedule as normal.
Treatment Duration and Withdrawal
There is no set duration for lithium therapy. Your doctor will continue prescribing lithium for as long as they think you need it—or until side effects emerge. This means you may take lithium for months or even years.
Do not stop taking lithium simply because you feel better. Lithium is not a cure for any of the conditions it treats. It simply helps regulate and manage their symptoms.
Though lithium is not addictive, you may experience some “withdrawal” symptoms. Any drug that alters your brain chemistry, like antidepressants or mood stabilizers, can have this effect. It takes time for your brain and body to adjust after you stop taking the drug. This is why doctors will slowly wean you off lithium when it is time to stop taking it.
Parting Words
A diagnosis of bipolar disorder, schizophrenia, or major depression can be debilitating and overwhelming. Lithium has helped many people learn how to manage their symptoms and dramatically improve their quality of life.
If you have questions about lithium or are wondering if it might help you or a loved one, don’t hesitate to reach out. Our medical team has decades of experience in lithium therapy for bipolar disorder and other conditions. You can reach us online or give us a call at (877) 810-2074.
