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Some side effects may pass with time, but others may require changes in the medication. Any other psychiatric or medical problems you have All other medications you are currently taking including over the counter products, herbal and nutritional supplements and any medication allergies you have Other non-medication treatment you are receiving, such as talk therapy or substance abuse treatment.
Your provider can explain how these different treatments work with the medication. If you are pregnant, plan to become pregnant, or are breast-feeding If you drink alcohol or use illegal drugs How Should I Take Lithium? Lithium is usually taken times per day with or without food. Liquid: Measure with a dosing spoon or oral syringe, which you can get from your pharmacy. Avoid low sodium diets and dehydration because this can increase the risk of lithium toxicity.
What are possible side effects of lithium? Hypothyroidism low levels of thyroid hormone may occur with long-term lithium use. Summary of Black Box Warnings Lithium toxicity Lithium toxicity is closely related to lithium blood levels and can occur at doses close to therapeutic levels; lithium levels should be monitored closely when starting the medication or if individuals experience side effects of the medication.
Look on the pill packet to find out what to do. Read more about what to do if you're on the pill and you have diarrhoea. There is no clear evidence that lithium affects female fertility. However, there is small chance that it can reduce sperm count in men. However, it's best to avoid a low-sodium low-salt diet as this can increase the levels of lithium in your blood and increase the chance of getting side effects.
The amount of fluids you drink is very important as it can affect the levels of lithium in your blood. Getting dehydrated will affect the levels so it's good to drink plenty of fluids. Some people may put on weight when taking lithium. Try to eat well without increasing your portion sizes.
Regular exercise can also help to keep your weight stable. When you first start taking lithium — or if the dose has recently been changed — it may make you feel tired, dizzy, sleepy and make your hands shake. You're recommended to stop doing these things for the first few days, until you know how lithium affects you and until you feel more alert. Taking ecstasy while you're on lithium can make you dehydrated, which can lead to lithium toxicity.
Page last reviewed: 18 August Next review due: 18 August About lithium Lithium is a type of medicine known as a mood stabiliser.
It's used to treat mood disorders such as: mania feeling highly excited, overactive or distracted hypo-mania similar to mania, but less severe regular periods of depression , where treatment with other medicines has not worked bipolar disorder , where your mood changes between feeling very high mania and very low depression Lithium can also help reduce aggressive or self-harming behaviour.
Lithium is available on prescription. The most common side effects of lithium are feeling or being sick, diarrhoea, a dry mouth and a metallic taste in the mouth. Your doctor will carry out regular blood tests to check how much lithium is in your blood. The results will be recorded in your lithium record book. Lithium carbonate is available as regular tablets and modified release brand names include Priadel, Camcolit and Liskonium. Lithium citrate comes as a liquid and common brands include Priadel and Li-Liquid.
Lithium can be taken by adults and children over the age of 12 years. Lithium may not be suitable for some people. Tell your doctor if: you have ever had an allergic reaction to lithium or other medicines in the past you have heart disease you have severe kidney problems have an underactive thyroid gland hypothyroidism that is not being treated you have low levels of sodium in your body — this can happen if you're dehydrated or if you're on a low-sodium low-salt diet you have Addison's disease , a rare disorder of the adrenal glands you have, or someone in your family has, a rare condition called Brugada syndrome — a condition that affects your heart you need to have surgery in hospital you are trying to get pregnant, are pregnant or breastfeeding Before prescribing lithium, your doctor will do some blood tests to check your kidney and thyroid are OK.
It's important to take lithium as recommended by your doctor. How to take it Swallow tablets whole with a drink of water or juice. Information about your lithium treatment When you start taking lithium, you will get a lithium treatment pack usually a purple folder or book with a record booklet.
When you go to the doctor for blood tests, you or your doctor will write in the record booklet: your dose of lithium your lithium blood levels any other blood test results your weight The treatment pack also has a lithium alert card.
Tell your doctor or pharmacist if you've lost your treatment pack or did not get one. Will my dose go up or down? Important Do not stop taking lithium suddenly or change your dose without speaking to your doctor first. What if I'm ill while taking lithium? Talk to your doctor or pharmacist if you: have an illness that causes severe diarrhoea, vomiting, a high temperature or sweating have a urinary tract infection UTI are not eating and drinking much What if I forget to take it? If you usually take: tablets or slow-release tablets — if it's less than 6 hours since you were supposed to take your lithium, take it as soon as you remember.
If it is more than 6 hours, just skip the missed dose and take your next one at the usual time liquid — if you forget to take a dose, just skip the missed dose and take your next one at the usual time Never take 2 doses at the same time.
Never take an extra dose to make up for a forgotten one. What if I take too much? It can cause symptoms such as: feeling or being sick problems with your eyesight blurred vision increased need to pee, lack of control over pee or poo feeling faint, lightheaded or sleepy confusion and blackouts shaking or muscle weakness, muscle twitches, jerks or spasms affecting the face, tongue, eyes or neck. Common side effects These are usually mild and go away by themselves.
You have 1 or more of these symptoms: loss of appetite, feeling or being sick vomiting problems with your eyesight blurred vision feeling very thirsty, needing to pee more than normal, and lack of control over pee or poo feeling lightheaded or drowsy confusion and blackouts shaking, muscle weakness, muscle twitches, jerks or spasms affecting the face, tongue, eyes or neck difficulty speaking These are signs of lithium toxicity. How to avoid high lithium levels in your blood Make sure that you go for the blood tests arranged by your doctor.
Serious allergic reaction: In rare cases, lithium may cause a serious allergic reaction anaphylaxis. What to do about: feeling or being sick — take lithium with or after a meal or snack.
It may also help if you do not eat rich or spicy food. If you are being sick, take sips of water to avoid dehydration. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee. Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor. If this does not help, talk to your pharmacist or doctor. Try not to have drinks with a lot of calories in as this might also mean you put on weight.
These symptoms can be a sign that the dose is too high for you. Your doctor may change your dose or recommend taking your medicine at a different time of day. If these symptoms do not get better within a week or two, your doctor may either reduce your dose or increase it more slowly. If that does not work you may need to switch to a different medicine. Regular exercise will help to keep your weight stable and help you feel better. Lithium and pregnancy Lithium is not usually recommended in pregnancy, especially during the first 12 weeks first trimester where the risk of problems to the baby is highest.
Lithium and breastfeeding If your doctor or health visitor says your baby is healthy, you can take lithium while breastfeeding. Non-urgent advice: Talk to your doctor if you:.
Check with your doctor or pharmacist if you're taking or before you start taking : tablets that make you pee diuretics such as furosemide or bendroflumethiazide non-steroidal anti-inflammatory drugs NSAIDs — used for pain relief and swelling such as aspirin , ibuprofen , celecoxib or diclofenac medicines used for heart problems or high blood pressure such as enalapril , lisinopril or ramipril ACE inhibitors some medicines used for depression such as fluvoxamine, paroxetine or fluoxetine antibiotics such as oxytetracycline, metronidazole, co-trimoxazole, trimethoprim medicines for epilepsy such as carbamazepine or phenytoin These are not all the medicines that can affect the way lithium works.
Mixing lithium with herbal remedies or supplements It's not possible to say whether complementary medicines and herbal supplements are safe to take with lithium. Important For safety, tell your doctor or pharmacist if you're taking any other medicines, including herbal remedies, vitamins or supplements. How does lithium work? How long does it take to work? Lithium may take several weeks or months to work. How will it make me feel? How long will I take it for? Some people need to take lithium for many years.
What will happen if I stop taking it? Acute-on-chronic toxicity occurs when a person who regularly takes lithium takes too much of it, either accidentally, deliberately, or because they received the wrong dose.
The symptoms of acute-on-chronic toxicity can vary from mild to severe, depending primarily on how much more lithium the person has taken compared with their regular dose.
Chronic toxicity occurs when a person who takes lithium in the long term undergoes a change in how their body eliminates or absorbs lithium. Other medical conditions, especially kidney conditions, are usually responsible for this change. However, factors that increase salt reabsorption in the kidneys can also increase lithium reabsorption. These include:. People with chronic lithium toxicity often have symptoms that do not seem to correspond with blood lithium levels.
The reason for this is that lithium accumulates in the bodily tissues. Chronic accumulation also means that symptoms can last for days, weeks, or even months after the person stops taking lithium, as it takes time to leave the bodily tissues.
Lithium tends to accumulate the most in the brain and kidneys. It builds up to a lesser extent in the thyroid, bones, muscles, and liver. With early detection, accurate diagnosis, and effective treatment, most cases of lithium toxicity resolve without any long-term complications. However, severe lithium toxicity carries the risk of permanent neurological damage, especially cerebellum conditions.
The longer someone experiences symptoms, the more likely they are to experience long-term complications. For example, if symptoms continue for more than 2 months after the person stops taking lithium, they are at an increased risk of developing permanent neurotoxicity, which can degrade the fibers that protect nerves.
People with chronic lithium toxicity also seem more likely to develop more severe complications than people with acute or acute-on-chronic cases.
Renal toxicity, which involves conditions that impair the function of the kidneys or their ability to concentrate urine, is more common in people who use lithium in the long term. People who take lithium for extended periods are also more likely to develop thyroid conditions, especially hypothyroidism , as lithium can interfere with the production and release of thyroid hormones.
In rare instances — usually very severe cases or those that additional health conditions complicate — lithium toxicity can also cause:. There is no specific treatment to reverse lithium toxicity.
Several types of therapy may help stabilize people with severe or chronic cases of toxicity, including:. Anyone who takes lithium and experiences signs or symptoms of lithium toxicity should stop taking the medication and talk with a doctor as soon as possible.
They should go to an emergency department or call or Poison Control in the U. Prompt diagnosis and treatment of lithium toxicity can usually reduce the risk of severe or permanent complications.
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