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Generic name: lithium carbonate; trade name: Eskalith, Lithane, Lithobid. Lithium.

Lithium is used for a variety of conditions, including major depression (“unipolar” depression) and bipolar disorder. It has both antidepressant effects and antimanic effects, although its well-known antimanic effects are somewhat stronger. Around the world, it is the medication used most often to treat bipolar disorder. Lithium is a naturally occurring mineral that is similar to sodium and potassium.

Although lithium will reduce severe manic symptoms in about 5 to 14 days, it may be weeks to several months before the condition is fully controlled. Antipsychotic medications are sometimes used in the first several days of treatment to control manic symptoms until the lithium begins to take effect.

Some people respond well to maintenance treatment and have no further episodes. Others may have moderate mood swings that lessen as treatment continues, or have less frequent or less severe episodes. For some people, lithium is not effective.

With regular monitoring, lithium is a safe and effective drug that enables many people, who otherwise would suffer from incapacitating mood swings, to lead normal lives. But it’s important to be aware of precautions, side effects and risks.

Take each dose as prescribed.
Do not stop taking lithium when you begin to feel better. Stopping it suddenly may make symptoms come back fast, and with intensity.

Periodic blood tests are advised to measure for safe and effective lithium levels.
Too little lithium will not be effective; too much can be dangerous. How much lithium people need to take may vary over time. Levels can be affected by certain medications, such as blood pressure medication or anti-inflammatory medication like ibuprofen/Motrin or naproxen/Naprosyn.

Side effects can include:

• drowsiness
• weakness
• nausea
• fatigue, hand tremor
• a lack of coordination
• mild diarrhea
• increased thirst and urination

Some of the above may disappear or decrease over time or may be managed by lowering the dosage.

Weight gain is common. Difficulty thinking, learning and remembering can occur, especially at higher doses.

Avoid coffee, tea, and cola
Caffeine can decrease lithium levels in your body.

Dehydration
Make sure you drink plenty of water in hot weather, during activities that cause you to sweat or if you are experiencing vomiting and/or diarrhea to avoid the risk of serious side effects. Dehydration can cause your body to retain sodium and, in the process, retain lithium.

A lithium overdose can be life-threatening.
Signs may include nausea, vomiting, drowsiness, mental dullness, slurred speech, blurred vision, confusion, dizziness, muscle twitching, irregular heartbeat, and, ultimately, seizures.

Thyroid function
Because lithium may cause the thyroid gland to become underactive (hypothyroidism) or sometimes enlarged (goiter), thyroid function monitoring is a part of the therapy. To restore normal thyroid function, thyroid hormone may be given along with lithium.

Other health conditions
Doctors either may not recommend lithium or may prescribe it with caution when a person has thyroid, kidney, or heart disorders, epilepsy, or brain damage. Tell your doctor if you might be or are planning to become pregnant. Lithium increases the risk of congenital malformations in babies.

Related articles
Understanding bipolar disorder
Coping with medication side effects
Tips for managing your medications
More articles

Sources:
Jim Phelps, M.D., author of Why Am I Still Depressed? and PsychEducation
National Institute of Mental Health, U.S. Department of Health and Human Services

Page updated February 1, 2010