Lithium

Lithium is a prescription medication used to treat and prevent episodes of mania in people with bipolar disorder (also known as manic-depressive disorder), a disorder that causes episodes of depression, mania, and other abnormal moods. Lithium belongs to a group of medications called antimanic agents. It works by decreasing abnormal activity in the brain.

Lithium is available as a tablet, capsule, and syrup and is usually taken 3 to 4 times a day.

Lithium is also available as an extended-release (long-acting) tablet to take by mouth. It is usually taken 2 or 3 times a day. Do not chew, crush, or divide extended-release lithium tablets. Swallow tablets whole.

Common side effects of lithium include uncontrollable shaking in the hands, increased urination, thirst, and nausea.

Lithium can also cause dizziness, drowsiness, and blurred vision. Do not drive or operate heavy machinery until you know how lithium affects you.

Lithium is a prescription medication used to treat and prevent episodes of mania in people with bipolar disorder (also known as manic-depressive disorder), a disorder that causes episodes of depression, mania, and other abnormal moods. Lithium belongs to a group of medications called antimanic agents. It works by decreasing abnormal activity in the brain.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Lithium may be found in some form under the following brand names:

• Eskalith

• Lithobid

• Lithostat

Serious side effects have been reported with lithium. See the "Lithium Precautions" section.

Common side effects of lithium include:

• fine hand tremor
• increased urination
• thirst
• nausea

This is not a complete list of lithium side effects. Ask your doctor or pharmacist for more information.

Tell your doctor if you have any side effect that bothers you or that does not go away.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• acetazolamide (Diamox)
• aminophylline
• angiotensin-converting enzyme (ACE) inhibitors such as benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril, lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), and trandolapril (Mavik)
• angiotensin II receptor antagonists such as candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro), losartan (Cozaar), olmesartan (Benicar), telmisartan (Micardis), and valsartan (Diovan)
• antacids such as sodium bicarbonate
• caffeine (found in certain medications to treat drowsiness and headaches)
• calcium channel blockers such as amlodipine (Norvasc), diltiazem (Cardizem, Dilacor, Tiazac, others), felodipine (Plendil), isradipine (DynaCirc), nicardipine (Cardene), nifedipine (Adalat, Procardia), nimodipine (Nymalize), nisoldipine (Sular), and verapamil (Calan, Covera, Verelan)
• carbamazepine (Tegretol)
• medications for mental illness such as haloperidol (Haldol)
• methyldopa (Aldomet)
• metronidazole (Flagyl)
• nonsteroidal anti-inflammatory drugs (NSAIDs) such as celecoxib (Celebrex), indomethacin (Indocin), and piroxicam (Feldene)
• potassium iodide
• selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft)
• theophylline (Theolair, Theochron)

This is not a complete list of lithium drug interactions. Ask your doctor or pharmacist for more information.

Serious side effects have been reported with lithium, including:

• Lithium toxicity. Tell your healthcare provider right away if you have some or all of the following symptoms of lithium toxicity:
  • diarrhea
  • vomiting
  • drowsiness
  • muscular weakness
  • lack of coordination
  • giddiness
  • blurred vision
  • ringing in the ears
  • increased volume of urination
• Neuromuscular side effects. Tell your healthcare provider right away if you have some or all of the following symptoms of neuromuscular side effects:
  • ​tremor
  • muscle twitching
• ​Central nervous system side effects. Tell your healthcare provider right away if you have some or all of the following symptoms of central nervous system side effects:
  • ​seizures
  • slurred speech
  • dizziness
  • vertigo
  • incontinence of urine or feces
  • sleepiness
  • restlessness
  • confusion
• ​Cardiovascular side effects. Tell your healthcare provider right away if you have some or all of the following symptoms of cardiovascular side effects:
  • ​irregular heartbeat
  • low blood pressure
• ​Gastrointestinal side effects. Tell your healthcare provider right away if you have some or all of the following symptoms of gastrointestinal side effects:
  • ​decreased appetite
  • vomiting
  • nausea
  • diarrhea
• ​Dermatologic side effects. Tell your healthcare provider right away if you have some or all of the following symptoms of dermatologic side effects:
  • drying and ​thinning of the hair
  • exacerbation of psoriasis
  • loss of feeling in the skin
  • infections of the skin

Lithium can also cause dizziness, drowsiness, and blurred vision. Do not drive or operate heavy machinery until you know how lithium affects you.

Do not take lithium if you:

• are allergic to lithium or to any of its ingredients
• have kidney disease
• have cardiovascular disease
• are dehydrated
• are taking diuretics

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of lithium, there are no specific foods that you must exclude from your diet when receiving this medication.

However, it is important to follow a proper diet while taking lithium. This includes adequate amounts of salt and liquids in your diet. Ask your doctor about the diet that is right for you. Also talk to your doctor about drinking drinks that contain caffeine while taking lithium.

Before taking lithium, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• are allergic to lithium or to any of its ingredients
• have kidney disease
• have cardiovascular disease
• have organc brain syndrome
• have thyroid disease
• have fainted without explanation
• have a family history of Brugada syndrome or if anyone in your family died suddenly with no explanatin before the age of 45

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X - are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Lithium falls into category D. It has been shown that the use of lithium in pregnant women caused some babies to be born with problems. However, in some serious situations, the benefit of using this medication may be greater than the risk fo harm to the baby.

Tell your doctor if you are breastfeeding or plan to breastfeed.

Lithium has been detected in human breast milk. Lithium should not be used by nursing mothers, except in rare and unusual circumstances in which, in the view of the physician, the potential benefits to the mother outweigh possible hazards to the child.

Take lithium exactly as prescribed.

Lithium is available as a tablet, capsule, and syrup and is usually taken 3 to 4 times a day.

Lithium is also available as an extended-release (long-acting) tablet to take by mouth. It is usually taken 2 or 3 times a day. Do not chew, crush, or divide extended-release lithium tablets. Swallow tablets whole.

If you miss a dose, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take 2 doses of lithium at the same time.

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The dose your doctor recommends may be based on the following:

• the condition being treated
• how you respond to this medication

The recommended dose of lithium for acute episodes of mania is 600 mg 3 times a day.

The recommended dose of lithium for long-term control and prevention of episodes of mania is 300 mg 3 or 4 times a day.

Doses of lithium should be individualized on the basis of response to therapy and levels of lithium in your blood.

If you take too much lithium, call your healthcare provider or local Poison Control Center or seek emergency medical attention right away.

If lithium is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.

• Store lithium at room temperature.
• Protect this medication from moisture.
• Keep this and all medications out of the reach of children.

Warning

Lithium toxicity is closely related to serum lithium levels, and can occur at doses close to therapeutic levels. Facilities for prompt and accurate serum lithium determinations should be available before initiating therapy.