Approved in the United States in the 1970s, lithium remains one of the most widely used and effective treatments for bipolar disorder. While effective, lithium does have side effects and people diagnosed with bipolar who take it may need to be monitored frequently by their doctor to ensure the drug is not hurting them.
Where It Fits In
Medication is considered a core portion of bipolar treatment plans, and lithium is considered among the most important of the medications that can be used because of its wide-ranging effectiveness in stabilizing mood.
How Does It Work
Lithium is a mood stabilizer. It can ease the symptoms of the manic and depressive phases associated with bipolar disorder and decrease the chance of a person having them recur. But lithium needs time—up to a few weeks—to build up in the body before it reaches peak effectiveness. In the case of sudden or acute bipolar episodes, it may need to be prescribed with other drugs if it has not reached the optimal level in the patient's system.
Who Can Take It
Lithium is a widely prescribed drug for bipolar disorder, but some segments of the population should take extra care when using the drug. They include people who have kidney or thyroid problems, and women who are pregnant or intending to become pregnant. People about to start lithium treatments should also tell their doctor about any other medications they are taking to prevent or minimize problems when lithium is introduced into their systems.
The dosage and level of lithium in a person's system needs to be monitored regularly to ensure that the proper level is maintained in the body. Too much lithium in a person's system can be toxic and cause damage. A person's overall health determines what the right level of lithium is for them.
Signs of toxicity can include nausea and diarrhea, problems with coordination and mental changes such as an inability to concentrate, drowsiness and disorientation.
In severe cases, toxicity can cause a coma.
Lithium can also damage the kidneys and interfere with the function of the thyroid, but monitoring can again spot these problems before they become serious, allowing physicians to mitigate them.
There is at least some indication that lithium when taken by pregnant women is associated with Ebstein's Anomaly, which is a malformation in the heart. It has also been linked with muscle weakness, and abnormal thyroid and kidney function in newborns.
Nursing mothers should also be aware that lithium in their system can be transferred into their breast milk.
Other potential and more common side effects include:
- frequent urination
- excessive thirst
- weight gain
- memory problems
- hand tremors
- hair loss
- water retention
These can often be managed by adjustments in dosage.
Lithium is commonly available under the names Eskalith or Lithobid. Other names include Duralith, Lithane, and Lithotabs.
It can be taken as a pill or liquid form.
Lithium is the first effective drug used to treat bipolar disorder.
Despite having been around for decades, it is still one of the most widespread and effective treatments for the disorder.
Lithium can produce side effects, but the most serious are also the more rare, and in most cases, the side effects can be managed.
What The Expert Says
Dr. Soroya Bacchus, a psychiatrist practicing in Los Angeles, said that lithium by itself and mixed in any combination with other bipolar disorder treatments like anticonvulsants or antipsychotics, is effective for both manic and depressive symptoms.
"Lithium is the gold standard for bipolar disorder," Dr. Bacchus said.