Lithium is a naturally occurring mineral which is often administered as a psychotropic drug in salt form. Lithium impacts the flow of sodium in both nerve cells and muscle cells. Due to its sedating effects, lithium is often used as a mood stabilizer. It may also be used to augment and improve the effectiveness of other psychiatric drugs. Common brand names for lithium-based medications include Cibalith-S, Eskalith, Eskalith CR, Lithane, Lithizime, Lithobid, Lithonate, and Lithotabs. Note that, according to the U.S. Food and Drug Administration (FDA), Eskalith and Eskalith CR are no longer on the market.
Lithium is primarily used to reduce and prevent mania in people experiencing bipolar issues. The exact mechanism by which this drug alleviates manic episodes is currently unknown. Lithium may also be used to treat individuals with suicidal ideation, depression, schizophrenia, impulsivity, disordered eating, cluster headaches, neutropenia, and even certain mental health issues in children. Though lithium may help individuals deal with the symptoms associated with these health conditions, it may not cure the diagnosis.
- How should I take this medication?
Lithium may be taken as a tablet, extended-release tablet, capsule, powder, syrup, or an oral solution. Take this medication exactly as prescribed by your doctor. Extended-release tablets are usually taken two to three times per day and should be swallowed whole; avoid biting, chewing, sucking, or crushing these tablets as they are intended to release medicine slowly into the body. Tablets, capsules, powders, syrups, and oral solutions are generally taken three to four times per day. One to three weeks may pass before you begin to experience the full therapeutic effects of this drug. Your doctor may increase or decrease your dosage depending on your response to the medication. Keep taking lithium as directed by your doctor even if you begin to feel consistently healthy. Check the medication guide each time you refill your supply of lithium as new information may have been added.
- What should I do if I forget to take a dose?
Take the dose you missed as soon as possible. If it is close to the time for your next regular dose, then skip the missed dose. Do not take a double dose. Taking too much lithium over a short period of time may lead to an overdose.
- What should I do if I overdose on this medication?
If you believe you may be overdosing on lithium, contact a poison control center, call your doctor, and seek urgent medical care at once. Lithium overdose is a medical emergency and needs to be addressed as quickly as possible. Signs of overdose may include vomiting, dizziness, diarrhea, frequent urination, disorientation, ringing in the ears, sleepiness, blurred vision, and muscle weakness.
- Who should not take this medication?
People who display allergic reactions to lithium, or those who are currently taking amifampridine, Cymbalta (duloxetine), Prozac (fluoxetine), or Zoloft (sertraline) should not take lithium-based drugs. Children under the age of 6 should not take this medication. Do not share your medication with any other person, even if he or she has been diagnosed with a similar health issue.
- How can I get the most out of my treatment with Lithium?
Many of the mental health conditions treated by lithium may also be effectively treated or managed with psychotherapy. If you are taking this medication for bipolar issues, depression,
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- How should I store this medication?
Keep this and all other drugs out of the reach of young children. Keep this medication tightly sealed in its original container. Store this medication at room temperature, away from excess heat or moisture.
Speak to your doctor if you are allergic to lithium. This medication may be toxic in large doses. This drug may adversely affect the water and sodium levels in the body, leading to dehydration and possible damage to the thyroid and kidneys. Improper use of this medication may be fatal.
Let your doctor know if you have a medical history of kidney disease, heart disease, neurodegenerative disease, epilepsy, thyroid issues, dehydration, hyponatremia (low blood sodium levels), Addison’s disease, or any other debilitating health condition. It is possible for lithium to interact with other drugs so inform your doctor of any other medications, sleep-aids, vitamins, minerals, dietary supplements, or herbal products you are currently taking or intend to take.
Elderly people may be more sensitive to the effects of this medication. If you are pregnant, inform your doctor of your condition before using this drug.
Lithium, like many other psychiatric drugs, carries significant risks of which you should be aware. If your doctor has prescribed this medication for you, speak to him or her about alternative options if you become pregnant during treatment. Lithium has been placed in FDA pregnancy category D, and may adversely affect an unborn baby. This drug may pass into breast milk and harm nursing infants.
This drug may cause drowsiness; do not participate in potentially dangerous activities such as driving a car, working with heavy machinery, or climbing until you discover how this medication affects you.
Avoid alcohol consumption while taking this medication as it may intensify potential side effects. Do not adjust your salt consumption as this may impact the amount of lithium in your blood. Drink enough liquids as instructed by your doctor in order to prevent dehydration. Drinking too much or too little liquid while taking lithium may have adverse effects. Speak to your doctor if you experience excessive sweating, vomiting, or diarrhea.
Keep all appointments and scheduled check-ups with your doctor to maintain treatment effectiveness and ensure proper kidney and thyroid function. If you intend to have surgery, inform your surgeon that you are taking this medication.
If you experience side effects from this medication, you should inform your healthcare provider right away. Serious side effects may include:
- More frequent or less frequent urination
- Extreme thirst
- Pain in the eyes, restless eye movements, and/or vision issues
- Restless muscle movements in neck, jaw, or tongue
- Weakness, light-headedness, confusion
- Fever with stiff muscles
- Slowed, increased, or uneven heart rate
- Cold sensations, pain, and discoloration in fingers and toes
- Symptoms of lithium toxicity (blurred vision, drowsiness, nausea, diarrhea, shaking, ringing in the ears, lack of coordination, etc.)
Less serious side effects may include:
- Loss of appetite, mild nausea, stomach pain
- Mild tremors in the hands
- Thinning hair
Work with your doctor on an appropriate strategy for reducing or stopping this medication; do not stop taking this medication on your own. While many people argue that abrupt discontinuation of lithium will produce no withdrawal symptoms (as it contains no addictive substances), the body may still struggle with the sudden change of not having the chemical present within its system. Some studies have also linked abrupt discontinuation with early reoccurrence of bipolar symptoms. To prevent these possible issues, it is best to follow the directions of your doctor.
- Citizens Commission on Human Rights International. (2012). The side effects of common psychiatric drugs. Retrieved from http://www.cchrint.org/pdfs/The_Side_Effects_of_Common_Psychiatric_Drugs.pdf
- Drugs.com. (2009). Lithium. Retrieved from http://www.drugs.com/lithium.html
- Mayoclinic. (2015). Lithium (oral route). Retrieved from http://www.mayoclinic.org/drugs-supplements/lithium-oral-route/description/drg-20064603
- Medline Plus. (2014). Lithium. Retrieved from https://www.nlm.nih.gov/medlineplus/druginfo/meds/a681039.html
- National Alliance on Mental Illness. (2012). Lithium. Retrieved from https://www.nami.org/Learn-More/Treatment/Mental-Health-Medications/Lithium
- National Health Service (n.d.). Lithium carbonate (lithium carbonate 200mg modified-release tablets). Retrieved from http://www.nhs.uk/Medicine-Guides/pages/MedicineOverview.aspx?condition=Depression&medicine=Lithium%20Carbonate
- WebMD. (n.d.). Lithium. Retrieved from http://www.webmd.com/vitamins-supplements/ingredientmono-1065-lithium.aspx?activeingredientid=1065&activeingredientname=lithium