Lithium

Key points

• Lithium may help prevent or treat episodes in bipolar disorder, but the response and target blood level are individual.
• Dehydration, acute illness and several common medicines can raise lithium levels and cause toxicity.
• Worsening tremor, repeated vomiting, unsteady walking, marked drowsiness or confusion needs urgent assessment.

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What Lithium is used for

Lithium is used in the treatment and prevention of episodes in bipolar disorder. It may also be added to specialist treatment for recurrent depressive disorder.

Important safety checks

Lithium levels, kidney and thyroid function and calcium may need monitoring. Tell the prescriber about diarrhoea, vomiting, fever, heavy sweating or a major dietary change. Anti-inflammatory painkillers, ACE inhibitors, ARBs and diuretics can alter lithium levels. Different formulations may release lithium differently and should not be substituted casually.

When to seek urgent care

Stop taking further doses and seek urgent clinical advice if lithium toxicity is suspected, especially with worsening tremor, repeated vomiting or diarrhoea, muscle weakness, slurred speech, poor coordination, unusual drowsiness, confusion or a seizure.

Further reading

• Lithium: MedlinePlus Drug Information
• Lithium - StatPearls - NCBI Bookshelf - NIH