Lithium Side Effects - Bipolar Medications

Lithium is a drug often prescribed as a mood stabilizer for people with bipolar disorder. It is sold under many brand names, including Duralith, Eskalith, Lithobid, Lithotabs, Lithane, Lithizine, and Lithonate.

If you are taking lithium, it's important to be aware of this medication's possible side effects. We also share a few ways to help ease these effects, helping you to take this drug for bipolar disorder with less discomfort.

Common Side Effects of Lithium

Some of the most common side effects experienced when taking lithium include:

• Diarrhea
• Excessive urination
• Feeling thirsty
• Nausea
• Tremors

Typically, these effects are more annoying than problematic. However, if they persist or are bothersome, talk to your healthcare provider about your options.

Your provider may make changes to your bipolar treatment protocol to help minimize the effects of this drug. Options include taking the medication at a different time of day, reducing the lithium dose, or prescribing another medication to help manage the negative effects.

Serious Side Effects of Lithium

Although rare, serious side effects can occur when taking lithium, one being diabetes insipidus. Diabetes insipidus causes the body to produce too much urine, resulting in constant thirstiness and frequent urination. This condition develops in roughly 20% of people taking lithium.

Not replacing the excessive amount of urine lost can lead to severe dehydration and cause seizures, permanent brain damage, and even death. This makes it important to talk to your physician right away if you experience excessive thirst or urination when taking lithium, to diagnose or rule out diabetes insipidus.

Lithium Toxicity or Overdose

Other serious side effects can occur if you take more than the prescribed amount of lithium, resulting in lithium toxicity or overdose. Even small amounts of too much lithium taken slowly over time can lead to overdose as this drug has a narrow safety range.

Signs of lithium overdose include:

• Confusion
• Severe hand tremors
• Severe nausea and vomiting
• Unsteadiness when standing or walking
• Vision changes

Long-Term Side Effects of Lithium

Taking lithium for long periods of time can also lead to certain side effects, namely hypothyroidism and kidney problems. Hypothyroidism refers to an underactive thyroid and low thyroid hormone levels. This causes the body to slow down and can lead to fatigue, weight gain, dry skin, slowed heart rate, and depression.

Diabetes insipidus is a kidney issue that can also develop due to long-term lithium use, with end-stage renal disease (ESRD) being another. ESRD involves a permanent loss of kidney function, potentially leading to dialysis or the need for a kidney transplant.

How to Ease Lithium Side Effects

In addition to starting with a lower dose of lithium before raising the dosage as tolerable, there are a handful of ways to help keep side effects to a minimum. They include:

• Taking your medication with food to avoid abdominal upset or nausea
• Using an anti-diarrheal medication for a time to help resolve lithium diarrhea, until your system adjusts to the drug
• Taking doses throughout the day instead of using an extended-release form
• Sucking on a sugar-free lozenge to relieve dry mouth
  

History of Lithium Use

Lithium was first used for mental illnesses in the mid-19th century but fell out of favor in the psychiatric world until it was brought back into use to treat mania around 1949. It has proven through time and research to be one of the most effective treatments for bipolar disorder in keeping moods stable and mood episodes at bay.

There has been renewed interest in the use of lithium recently because of its tolerability and effectiveness. Though it has side effects, these can generally be kept to a minimum by starting with a low dose and gradually increasing to the desired strength.

Summary

Your healthcare provider can give you tips to help you deal with the side effects of lithium until your system adjusts. If you experience side effects that do not go away after a time, talk to your provider about lowering your dose. Many patients do well on a lower dose of lithium, and without the side effects.