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Lithium Side Effects: The 10 Most Common Side Effects | Schiz Life

Lithium Side Effects: The 10 Most Common Side Effects | Schiz Life

Even if you’ve never taken a psychiatric drug yourself, you probably know that all medications that treat mental illness are accompanied by an array of unwanted side effects. The common psychiatric drug lithium is no exception, but science and medical experts fortunately know a lot about medical lithium side effects from decades of use by patients. You have the right to inform yourself about lithium side effects. Whether you’ve been prescribed lithium, are thinking about taking a mood stabilizer, or you’re just curious about lithium as a medication, keep reading for more information about lithium side effects.

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What Is Lithium?

What Is Lithium
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Lithium side effects are only one aspect of an interesting and useful substance. You may have heard of lithium being used in a variety of contexts, from batteries to rockets to medicine. The word lithium always refers to the same metal, and it is well-known as a psychiatric medication.

The Science


the metal element Lithium
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Lithium is a naturally-occurring chemical element that appears on the periodic table directly below the element hydrogen. It is the lightest metal, the lightest solid element, and can be found in most rocks in trace amounts. Many studies from multiple countries have found that lower levels of lithium in a municipal water supply correlate with higher instances of suicide, homicide, rape, other violence, burglary, robbery, and crimes related to alcohol and drugs; in comparison, higher levels of lithium in the water were found to correlate with lower rates of violence and other crimes.

The Medicine


Lithium medication
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Among a dizzying variety of other uses, lithium is a medical treatment for certain mental illnesses and other health issues, usually taken orally in capsule form. The most common, established, and effective use of medical lithium is for treating the manic symptoms of bipolar disorder, previously known as manic-depressive disorder. It is also effective in treating schizophrenia. While lithium has been used to treat psychiatric disorders for generations, experts did not understand until 1998 exactly how it worked: by regulating the important and ubiquitous neurotransmitter glutamate, introducing lithium decreases manic symptoms such as hyperactivity, rushed speech, poor judgment, reduced need for sleep, aggression, and anger. Lithium is known as a “mood stabilizer.”

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Dosage and Interactions

Dosage and Interactions
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As with any drug, it’s important to find the best dosage of lithium for your body, needs, and lifestyle; it's also important to make sure you don’t combine lithium with drugs that may cause dangerous interactions or lithium overdose.

Dosage


Dosage and Interactions
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Prescribers usually divide treatments into multiple doses per day to reduce lithium side effects. Do not suddenly stop taking lithium, as doing so will likely trigger a manic episode; if you wish to discontinue taking lithium, talk to your health care provider about gradually step down your dose over 14 days. Dosage to treat the manic symptoms of bipolar disorder depends on whether lithium is being used in the short term or long term:


To treat an acute manic episode such as in a crisis situation, patients are usually prescribed 1.8g or 20-30mg per kg of body weight of lithium carbonate per day, divided into 2-3 doses throughout the day. To ease lithium side effects, some prescribers may start patients on a 600-900mg per day and gradually increase the dose.


For long-term maintenance treatment of schizophrenia, bipolar disorder and other psychiatric conditions, patients usually take 900mg to 1.2g of lithium carbonate per day divided into 2-4 doses. While treatment of mania in children has not been studied as long or as well as treatment of mania in adults, children have successfully taken 15-60 mg/kg per day in divided doses.

Drug Interactions


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Take care when combining a lithium treatment with other drugs. Lithium toxicity, serotonin syndrome, and other interactions may result. Be sure to tell your health care provider about other medications you are taking before starting lithium treatment.


Combining drugs that increase serotonin in the brain may result in symptoms related to excessive serotonin in the body, collectively known as serotonin syndrome. Serotonin syndrome is a major drug interaction marked by serious symptoms including cognitive effects such as headache, agitation, hypomania, confusion, hallucinations, and coma; autonomic effects such as heart problems, shivering, sweating, fever, and diarrhea; and somatic effects such as muscle twitching and tremor. To prevent serotonin syndrome, do not combine the following depression medications with lithium:

  • Antidepressants
  • MAOIs

Be cautious and talk to your health care provider when combining lithium with the following drugs, as they may cause moderate interactions such as serotonin syndrome, increased or decreased lithium levels, or decreased medication efficacy:

  • Dextromethorphan
  • ACE inhibitors for high blood pressure
  • Calcium channel blockers for high blood pressure
  • Anticonvulsants for seizures
  • Meperidine (Demerol)
  • Methyldopa (Aldomet)
  • Methylxanthines
  • Muscle relaxants
  • NSAIDs
  • Phenothiazines
  • Tramadol (Ultram)
  • Water pills (Loop diuretics and Thiazide diuretics)

Take care when combining the following drug with lithium, as it may cause minor serotonin syndrome syndromes and is considered a minor interaction:

  • Pentazocine (Talwin)

Lithium Toxicity


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There are many causes of lithium toxicity or lithium overdose, including drug interactions. The following are common signs of lithium toxicity or lithium overdose. Address these symptoms with a doctor right away:

  • Vomiting or severe nausea
  • Severe tremor in extremities
  • Frequent muscle twitching
  • Blurred vision
  • Dizziness
  • Difficulty walking
  • Slurred speech
  • Irregular heartbeat
  • Swelling of feet or legs
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10 Lithium Side Effects

Medical lithium is associated with a variety of side effects. 10 of the most common lithium side effects are listed below.

Weight Gain

Nausea 

Diarrhea

Excessive Urination

Excessive Thirst

Tremor

Cognitive Impairment

Sexual Dysfunction

In patients taking lithium, sexual dysfunction, including erectile dysfunction, is a well-known but not well-studied side effect. Sexual dysfunction may affect your confidence and your relationships. A daily aspirin regimen may ease sexual dysfunction symptoms. If you experience erectile dysfunction, you can also ask your health care provider if it’s safe for you to take a phosphodiesterase 5 inhibitor such as Viagra.

Acne

Lithium is known to cause acne or make acne worse. Use general acne remedies to treat this lithium side effect. When using acne products that dry the skin, don't forget to hydrate your skin.

Psoriasis

Like acne, psoriasis is another skin condition exacerbated by lithium. The supplement inositol may treat psoriasis.

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Conclusion

Lithium side effects are no fun, but the conditions lithium treats aren't pleasant either. As with other medications, and psychiatric medications in particular, the decision to take or continue taking lithium requires some cost-benefit analysis: you will have to weigh the pros and cons. You may not know if the lithium side effects are worth the therapeutic effects until you actually try the medication. Some lithium users experience little to no side effects when taking lithium. Many lithium users find that the positive effects lithium has on their daily lives are worth the unpleasant side effects. Others choose to seek other treatments because the side effects of lithium are more unpleasant than they are willing to tolerate. Everyone's body responds to illness and medication differently.

Talk with your health care provider about your concerns with lithium side effects. If you choose to take lithium, be mindful of the common side effects, as well as the dangerous side effects and drug interactions associated with lithium. Your mental health deserves the best care.

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