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Medically Reviewed by Dr P. E. Pancoast, MDÂ
Lithium (lithium carbonate) is a mood stabilizer medication prescribed to treat mental disorders, including bipolar disorder, depression, and schizophrenia.
Lithium is an antimanic agent, and it works to treat affective disorders by decreasing abnormal activity in the brain. Lithium is available as a tablet, capsule, extended-release (long-acting) tablet, and solution (liquid) to take by mouth.
The brand names of lithium include Eskalith and Lithobid.
To treat bipolar disorder, also known as manic-depressive disorder, lithium is used alone or with other medications such as benzodiazepines, Risperdal, or citalopram. Lithium is often prescribed as maintenance therapy in between manic episodes in patients with bipolar disorder.
Research shows that lithium can significantly reduce suicide risk in patients with mood disorders.Â
Some patients who take lithium for bipolar disorder experience side effects. These side effects may subside or decrease in severity as the patient’s body gets used to the drug. Common side effects of lithium include:
In rare cases, lithium may cause a reversible condition known as diabetes insipidus. If this occurs, patients will notice a significant increase in thirst and frequency of urination. Patients who experience these symptoms should talk to their healthcare provider to check for and prevent this condition.
Lithium toxicity, also called lithium overdose and lithium poisoning, is a potentially deadly condition of having dangerously high levels of lithium in the blood. Drug interactions in the body also cause this condition.
Doctors prescribing and monitoring people taking lithium commonly order blood levels of the lithium to be sure the amount of lithium in the body is therapeutic. This testing discovers most cases of improper dosing that result in lithium toxicity.
Symptoms of lithium toxicity include:Â
These symptoms indicate that lithium levels are dangerously high. Patients who experience these symptoms should stop taking lithium and seek medical care immediately. Lithium toxicity is a potentially life-threatening event and should be attended to urgently by a healthcare professional. If untreated, lithium toxicity can result in death.
Some medications can increase the levels and effects of lithium and cause lithium toxicity, including:
Patients taking these medications should not take lithium.Â
Lithium should generally not be prescribed to patients with significant kidney or heart disease, severe debilitation or dehydration, sodium depletion, and patients receiving diuretics. The risk of lithium toxicity is greatly increased in these patients.
Some medications and substances may decrease the levels and effectiveness of lithium. Patients should avoid the following medications and substances while taking lithium:
Patients should disclose any medications and substances they take to their doctor prior to taking lithium to prevent any harmful drug or substance interactions.
Lithium is not addictive except in the sense that anything can become psychologically addictive. Lithium does not cause any physical dependency in people taking it, as is the case with alcohol or opiates. Even though lithium is not a naturally addictive substance, it can still be used improperly or mixed with addictive substances which can cause dangerous interactions, and in some cases, death.Â
Drinking alcohol while on lithium is not safe. For patients on lithium, alcohol may decrease the benefits and increase the adverse effects of the medication.
Because Lithium is typically prescribed to patients with bipolar disorder, it is not recommended to mix lithium with alcohol, because ethanol, the primary ingredient in alcohol, also causes mood-altering effects. Both of these drugs affect the central nervous system.
When lithium and alcohol interact, they can counterbalance each other. Someone who mixes the two may find that their mental state gets worse as a result.
There are other considerations with mixing lithium and alcohol. One of these is the fact that alcohol is dehydrating. Because alcohol dehydrates the body, it can lead the amount of lithium in the blood to rise and become toxic.
People on lithium are advised to maintain a balanced diet, which can be interrupted by alcohol. Because of how heavily lithium affects sodium levels in the blood, it’s essential to be vigilant with salt consumption.
Lithium use is also associated with an increased risk of hypothyroidism. Drinking alcohol also harms thyroid levels.
Other illicit drugs, including marijuana and cocaine, can cause dangerous interactions with lithium. Individuals with substance use disorders should not be prescribed lithium.
When alcohol and lithium mix, they may cause:
Alcohol abuse complicates the management of bipolar disorder and other mood disorders. Drinking impairs judgment and makes the user more impulsive and more prone to injury or risky behavior.
Alcohol and lithium also increase the risk of suicide. The risk of suicide is nearly doubled in patients with bipolar disorder who abuse alcohol compared with patients who don’t.Â
Patients being treated with lithium who also abuse alcohol will likely be prescribed another mood stabilizer that does not interact with alcohol. They will also be referred to alcohol treatment, either inpatient, outpatient, or partial hospitalization, depending on their abuse severity.
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