What Happens When You Mix Alcohol and Lithium?

What is Lithium?

Lithium (lithium carbonate) is a mood stabilizer medication for managing and controlling emotions.^1,3 Research shows that lithium can significantly reduce suicide risk in patients with mood disorders.^4,5

Doctors often prescribe it to treat mental disorders, such as:³

• Bipolar disorder (manic-depressive disorder)
• Mania
• Hypomania (a less severe form of mania)
• Depression
• Schizophrenia

Effectivity and Forms of Lithium

Lithium may take several weeks or months to start working. You may need to be in a hospital to start lithium treatment.³

Lithium is known under the brand names Eskalith and Lithobid. It's available in the following forms:³

• Tablet
• Capsule
• Extended-release tablet
• Oral solution

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How Does Lithium Work?

Lithium is an antimanic agent that changes the release of chemicals like dopamine or serotonin in your brain.² These chemicals are responsible for making you feel good or happy.

Because of this, physicians often prescribe lithium to treat bipolar disorder and other affective disorders. It also works as maintenance therapy between manic episodes in people with bipolar disorders.³

You can also use it alone or with other medications to help you stay calm. These include:^2,3

• Benzodiazepines
• Risperdal
• Citalopram

Side Effects of Lithium

Some people who take lithium for bipolar disorder experience side effects. These side effects may subside or decrease in severity as your body gets used to the drug.

Drinking alcohol can also worsen or exacerbate them. It can also have negative effects on your mental health and overall well-being.

Common side effects of lithium include:^2,3

• Acne or rash
• Changes in the ability to taste
• Changes in appetite
• Constipation
• Depression
• Dry mouth
• Excessive salivation
• Gas
• Headache
• Indigestion
• Itching
• Joint or muscle pain
• Paleness
• Restlessness
• Stomach Pain
• Swollen lips
• Thinning or brittle fingernails 
• Thinning of hair or hair loss
• Unusual discomfort in cold temperatures
• Weight gain or loss

Does Lithium Have Rare Side Effects?

In rare cases, lithium may cause reversible diabetes insipidus. It's a rare disorder that causes your body to produce too much urine.^2,3

If you notice a significant increase in thirst and urination, contact your healthcare provider. They can help you manage or prevent this condition.

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Is it Safe to Mix Lithium and Alcohol?

Both alcohol and lithium affect the central nervous system with mood-altering effects. However, these substances counterbalance each other, meaning alcohol can decrease the benefits and increase the adverse effects of lithium.^2,3

Mixing lithium and alcohol can increase the risk of side effects, mental health issues, and other complications. It can worsen the symptoms of any underlying mental health disorder that you may have. There's also an increased risk of developing an alcohol use disorder (AUD).^2,3,5

You must also maintain a balanced diet when taking lithium because it can heavily affect sodium levels in the blood. However, alcohol consumption can interrupt this. Lastly, drinking alcohol can dehydrate the body and increase the amount of lithium in the blood, becoming toxic.^2,3

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What are Lithium and Alcohol Side Effects?

Mixing alcohol and lithium can complicate the management of bipolar disorder and other mood disorders. This is because drinking impairs judgment and increases the risk of injury from risky or impulsive behavior.

Other side effects of mixing alcohol and lithium may cause:^2,3

• Dizziness
• Drowsiness
• Impaired thinking and judgment
• Impaired motor functions
• Increased depression
• Liver Damage
• Severe nausea
• Vomiting
• Restlessness
• Sedation
• Tremors
• Joint pain
• Muscle pain

What are the Risks of Mixing Lithium and Alcohol

Lithium use can increase your risk of hypothyroidism. Drinking alcohol also harms thyroid levels.⁶

Alcohol and lithium also increase the risk of suicide. The risk of suicide is nearly doubled in people with bipolar disorder who abuse alcohol compared with those who don’t.⁵

Moreover, this combination can increase the risk of developing a dual diagnosis, which is a condition where you have both a mental health illness and a substance use disorder. In some cases, lithium can worsen alcohol withdrawal symptoms.^2,3

What are the Symptoms of Lithium Toxicity?

Lithium toxicity, or lithium overdose and poisoning, is a potentially deadly condition of having dangerously high levels of lithium in the blood. Drug interactions in the body can also cause this.^2,3

Doctors prescribing and monitoring people taking lithium commonly order tests on blood levels. This ensures that the amount of lithium in the body is therapeutic. Most cases of lithium toxicity are due to improper dosing.^2,3

Signs of Lithium Toxicity or Overdose

Symptoms of lithium toxicity include: 

• Blackouts
• Confusion
• Crossed Eyes
• Diarrhea
• Dizziness or drowsiness
• Fainting
• Hallucinations
• Hand tremors
• Headache
• Irregular heartbeat
• Loss of coordination
• Muscle weakness
• Nausea or vomiting
• Painful, cold, or discolored fingers and toes
• Pounding noises inside the head
• Seizures
• Shortness of breath or chest tightness
• Swelling of the feet, ankles, or lower legs
• Unusual tiredness or weakness
• Vision changes

You should stop taking lithium and seek medical care immediately if you experience these symptoms. Lithium toxicity is potentially life-threatening and requires urgent medical attention.^2,3

Who is At Risk of Lithium Toxicity

Certain substances and medications can affect the level of lithium in your body. People experiencing the following should not be prescribed lithium because it can increase the risk of lithium toxicity:^2,3

• Significant kidney or heart disease
• Severe debilitation or dehydration
• Sodium depletion
• Taking diuretics
• Substance use disorders (SUD)

Tell your doctor about your medications, substances, or supplements before taking lithium. This can prevent any harmful drug interactions.

What are Lithium Drug Interactions?

Combining lithium with alcohol can increase the risk of lithium toxicity. This is because alcohol can affect lithium levels in your blood.

Similarly, some medications can also increase lithium levels, causing toxicity. These include:¹

• Angiotensin-converting enzyme (ACE) inhibitors (such as lisinopril)
• Angiotensin receptor blockers
• Certain blood pressure medications
• Diuretics
• Monoamine oxidase inhibitors (MAOIs), a class of antidepressants
• Non-steroidal anti-inflammatory drugs (NSAIDs), including ibuprofen and other over-the-counter pain medications

Substances That Decrease Lithium Effectivity

On the other hand, some medications and substances can decrease the levels and effectiveness of lithium. You should avoid the following while taking lithium:¹

• Caffeine
• Sodium chloride (table salt)
• Theophylline (Theo–Dur®, Slo–Bid®)

Is Lithium Addictive?

Lithium isn't addictive and doesn't cause any physical dependency. However, some can still misuse or mix it with other addictive substances, leading to dangerous interactions and death.¹

Combining lithium with alcohol or other substances with addictive properties can also increase the risk of mental health disorders and substance abuse issues. Because of this, it's important to avoid mixing lithium with illicit drugs like marijuana and cocaine.¹

How Do You Treat Lithium & Alcohol Abuse?

Those under treatment for lithium and alcohol abuse will likely need another mood stabilizer that doesn't interact with alcohol. If you struggle with lithium and alcohol abuse, you need various treatment options for substance use disorders.

Treatment can depend on the severity of the abuse. These include:

• Medical detox: Medically-supervised detox avoids harmful withdrawal effects
• Inpatient treatment: Involves checking yourself into a rehab facility for 24-hour medical supervision
• Outpatient treatment: A treatment program where you can leave the rehab facility
• Partial hospitalization program: A treatment program where you stay at a rehab facility for a day and return home at night
• Dual diagnosis treatment: A treatment program that addresses co-occurring mental health conditions alongside addiction
• Cognitive behavioral therapy: A short-term therapy technique that explores the link between thought patterns and substance abuse
• Addiction counseling: Group or individual counseling that helps guide you through addiction, recovery, and sobriety
• Support groups: Groups like Narcotics Anonymous (NA) and Alcoholics Anonymous (AA) provide a community to help maintain sobriety after treatment

Summary

Lithium is a mood stabilizer for people with bipolar disorder. However, it can cause harmful interactions with alcohol and certain medications.

It's important to inform your doctor of all substances you are taking before starting lithium treatment. Additionally, misuse or abuse of lithium and other substances can lead to serious health consequences. They may also require treatment for substance use disorders.

If you or a loved one is struggling with lithium and alcohol abuse, seek help immediately. Treatment options for substance use disorders can help you achieve a healthier, sober life.