For some people, lithium can help decrease abnormal activity in the brain, manic episodes and suicidal feelings. Short-term side effects can include shaking, fatigue, headache and gastrointestinal problems, while a long-term side effect can be weight gain.
Lithium also exerts antisuicidal, immunomodulatory, and neuroprotective effects. The main problems associated with long-term lithium treatment include kidney, thyroid, and probably cognitive issues.
Excessive urination and thirst (polyuria and polydipsia) are consistently found to be among the most common side effects associated with lithium with rates up to 70% in long-term patients (Bone et al.
The three organ systems that may be negatively affected by lithium are the thyroid gland, kidneys and parathyroid glands.
Lithium May Extend Longevity
In addition to the well-known positive effects on mood,18 lithium has also been linked with longer overall longevity. Two studies have found that individuals living in areas with even modest, low levels of lithium in the drinking water tend to live longer.
Rarely, lithium is reported to cause irreversible, permanent neurological sequelae such as cerebellar impairment, dementia, parkinsonian syndromes, choreoathetosis, brain stem syndromes, and peripheral neuropathies.
Interestingly, lithium appears to preserve or increase the volume of brain structures involved in emotional regulation such as the prefrontal cortex, hippocampus and amygdala, possibly reflecting its neuroprotective effects.
Treatment of lithium-induced weight gain includes non-pharmacological measures such as exercise, avoidance of liquid calories and restricted calorie intake,14) as well as several medications that have been useful for psychotropic-induced weight gain.
Common drug–drug interactions with lithium
The most commonly prescribed drugs that have the potential to interact with lithium are ACE inhibitors, angiotensin II receptor antagonists (sartans), diuretics, and non-steroidal anti-inflammatory drugs (NSAIDs).
Approximately 25% of people gain weight from taking lithium, according to a review article published in Acta Psychiatrica Scandinavica. 1 After analyzing all relevant published medical studies, the authors reported an average weight gain of 10 to 26 pounds among those who experience this troubling side effect.
Symptoms of lithium toxicity include severe nausea and vomiting, severe hand tremors, confusion, and vision changes. If you experience these, you should seek immediate medical attention to check your lithium levels.
Lithium – When abruptly discontinued, people who have been taking lithium to stabilize moods may experience mood instability and a relapse of mania.
A common complaint made by those who take lithium, but one which may easily be overlooked, is cognitive compromise. Clinically, patients describe this as “brain fog”-an elusive admixture of complaints regarding attention, concentration, and memory occurring in conjunction with a slowing of thought processes.
Substantial affect and mood changes are induced by lithium carbonate. Lethargy, dysphoria, a loss of interest in interacting with others and the environment, and a state of increased mental confusion were reported.
What did the scientists find? In those exposed to lithium, 9.7% of patients were also subsequently diagnosed with dementia. In those that weren't exposed to lithium, 11.2% of people went on to develop dementia. Lithium conferred this beneficial effect even when people were exposed to it for less than one year.
If you suddenly stop taking lithium, one of the drugs most commonly prescribed to stabilize bipolar disorder moods, you can experience “rebound,” a worsening of your bipolar symptoms.
Adverse effects were the most common cause for lithium discontinuation. Among the adverse effects, diarrhoea, tremor, creatinine increase, polyuria/polydipsia/diabetes insipidus and weight gain were the top five reasons for discontinuing lithium.
Lithium may cause problems with kidney health. Kidney damage due to lithium may include acute (sudden) or chronic (long-term) kidney disease and kidney cysts. The amount of kidney damage depends on how long you have been taking lithium.
Establishing a sleep routine, staying hydrated, and exercising can combat fatigue. Limiting caffeine, increasing vitamin B-12 intake, and avoiding 'drowsy' medications can also help to boost energy levels.
Relapses can occur even when lithium is stopped only for a few days. Abrupt discontinuation of lithium seems to be associated with an increased risk of recurrence. The pathophysiology of this rebound effect is still unknown. In clinical practice, lithium discontinuation has to be gradual when possible.
Background: Though often perceived as a “silver bullet” treatment for bipolar disorder (BD), lithium has seldom reported to lose its efficacy over the time.
The treatment serum level range is 0.8-1.2 mmol/L, but Lithium levels above 1.2 mmol/L can be toxic and a level above 2.0 mmol/L is potentially fatal.
Typical dosing for lithium
The typical starting dose depends on what form of lithium you're prescribed. Lithium immediate-release tablets and capsules: Adults and children above 30 kg (66 lbs): The typical starting dose is 300 mg by mouth 3 times a day.