Lithium Treatment for Bipolar Disorder: What You Need to Know

Bipolar disorder is unique among mood disorders because it involves two opposite emotional states: depression and mania. Both of these mood extremes can significantly disrupt your daily life, making it essential to address and treat both effectively.

Lithium has stood the test of time as one of the most trusted medications for managing both manic and depressive phases of bipolar disorder.

Understanding Lithium

Lithium is classified as a mood stabilizer and is available in various forms including extended-release tablets, immediate-release tablets, capsules, and oral solutions. Being available as a generic medication, lithium is also cost-effective.

How Lithium Works in Bipolar Disorder Management

Lithium is primarily prescribed for long-term management of bipolar I disorder, which is characterized by severe manic episodes. As a first-line treatment, lithium helps reduce the severity and frequency of manic episodes and also eases depressive symptoms. While the exact mechanism of lithium’s mood-stabilizing effects remains unclear, its benefits are well-documented.

Because the therapeutic dose of lithium is close to its toxic dose, careful dosing and monitoring are essential. Your healthcare provider will likely start you on a low dose and adjust gradually to minimize the risk of lithium toxicity. Regular blood tests are necessary to ensure lithium levels remain within a safe and effective range.

Possible Side Effects of Lithium

Common Side Effects

At standard doses (900–1,800 mg/day), some side effects may occur, including:

• Fine hand tremors
• Increased urination
• Heightened thirst
• Nausea
• Diarrhea
• Vomiting
• Drowsiness
• Muscle weakness
• Coordination difficulties

Higher doses may cause additional effects such as dizziness, blurred vision, impaired muscle control during voluntary movements, and ringing in the ears.

Serious but Rare Side Effects

Although uncommon, lithium can lead to serious complications, especially in individuals with pre-existing health conditions or when combined with certain medications. For example, lithium may impair kidney function, potentially leading to reversible kidney failure, particularly in those with existing kidney disease. Your doctor will evaluate your kidney health before and during treatment.

In rare cases, lithium has been linked to triggering Brugada syndrome, a dangerous heart rhythm disorder predominantly affecting men of Southeast Asian descent. Symptoms like lightheadedness, abnormal heartbeats, or shortness of breath require immediate emergency attention.

Additionally, combining lithium with other psychiatric medications might rarely result in brain-related issues, presenting as weakness, fatigue, fever, confusion, or tremors. Always inform your healthcare provider about all medications and supplements you use to prevent harmful interactions.

What Is Bipolar Disorder?

Bipolar disorder is a chronic mental health condition marked by rapid and intense shifts between depressive and manic moods. It typically emerges in late adolescence or early adulthood and requires ongoing management, often involving lithium therapy.

Depressive episodes may present as:

• Persistent sadness
• Loss of interest in activities
• Appetite changes
• Weight fluctuations
• Sleep disturbances
• Fatigue
• Difficulty concentrating
• Thoughts of self-harm or suicide

Manic episodes may include:

• Elevated energy levels
• Rapid, racing thoughts
• Exaggerated self-confidence
• Poor impulse control
• Risky decision-making

Even mild mood swings can disrupt daily functioning, affecting relationships and work or school performance. Severe episodes increase the risk of suicidal behavior.

Learn more about calming your nerves with nutrition »

Consult Your Healthcare Provider

Lithium remains a cornerstone in managing bipolar disorder when taken as directed. However, it is not suitable for everyone, and improper use can lead to toxicity.

To ensure safe and effective lithium use, consider these recommendations:

• Provide your doctor with a complete medical history and a list of all medications and supplements you take.
• Follow your prescribed dosage strictly.
• Discuss potential side effects and your personal risk factors with your healthcare provider.
• Communicate openly about any concerns or symptoms you experience during treatment.

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Our medical experts provide this information for educational purposes only and it should not replace professional medical advice.

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