Lithium as Treatment for Bipolar Disorder

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Lithium is prescribed as a mood stabilizer for people who have bipolar disorder. It acts to help control the mania,hypomania, depression, and psychosis associated with the condition.

Lithium is a naturally occurring element that was found, in the late 1800s, to have mood-stabilizing properties. The first paper on using lithium to treat what was then called manic depression was published in 1949. The FDA approved lithium in 1970. Even now, the specific way lithium helps people with bipolar disorder is complex and not fully understood.

When Is Lithium Prescribed?

This drug is formally approved to treat manic episodes of bipolar disorder when symptoms such asgrandiosity, racing thoughts, hypersexuality,delusions,hallucinations, and decreased need for sleep appear. However, it has also been shown to help withdepressive symptoms,psychoticfeatures, and mixed episodes.

Some research has shown that lithium can also be useful in treating unipolar depression (depression without the mania seen in bipolar disorder) when added to one or more other depression medications, so doctors sometimes prescribe it for this, too.

Contraindications

Lithium can damage your kidneys, especially with long-term use. All patients should be screened for kidney problems before starting lithium and should be screened regularly while taking it as well.

If significant kidney problems show up in the initial testing, lithium should be prescribed only with great care and close monitoring. If kidney problems develop later, your doctor may consider discontinuing lithium, since it may be possible to reverse the damage once you stop taking the medication.

There are several medical conditions and circumstances that also require particular caution when lithium is prescribed:

Early studies indicate lithium may also be safe and effective for treatment of bipolar symptoms in children and adolescents.

Common Symptoms of Bipolar Disorder

Warnings About Lithium

There are several important warnings for people taking lithium. These include:

Precautions

Keep the following precautions in mind as well:

Drugs to Avoid When Taking Lithium

There is a long list ofmedicationsthat may interact negatively with lithium or increase the risk of side effects. Some drugs that are commonly prescribed for bipolar disorder fall into this category. They include:

People who are taking lithium should also avoid taking NSAIDs (non-steroidal anti-inflammatory drugs, such as ibuprofen) on a regular basis, diuretics such as HCTZ (used in hypertension) and furosemide (in heart failure), and ACE inhibitors (blood pressure).Also, tetracyclines can increase blood levels, while using large amounts of caffeine may actually decrease blood levels.

Lithium Side Effects

The most commonside effects of lithium, which may go away after initial use, are:

Weight gain over time is also common.

7 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Mohandas E, Rajmohan V.Lithium use in special populations.Indian J Psychiatry.2007;49(3):211-218. doi:10.4103/0019-5545.37325Coppen A.Lithium in unipolar depression and the prevention of suicide.J Clin Psychiatry. 2000;61 Suppl 9:52-56.Gitlin M.Lithium side effects and toxicity: prevalence and management strategies.Int J Bipolar Disord.2016;4(1):27. doi:10.1186/s40345-016-0068-yAmerio A, Ossola P, Scagnelli F, et al.Safety and efficacy of lithium in children and adolescents: A systematic review in bipolar illness.Eur Psychiatry.2018;54:85-97. doi:10.1016/j.eurpsy.2018.07.012Bedford JJ, Weggery S, Ellis G, et al.Lithium-induced nephrogenic diabetes insipidus: renal effects of amiloride.Clin J Am Soc Nephrol.2008;3(5):1324-1331. doi:10.2215/CJN.01640408Kibirige D, Luzinda K, Ssekitoleko R.Spectrum of lithium induced thyroid abnormalities: a current perspective.Thyroid Res. 2013;6(1):3. doi:10.1186/1756-6614-6-3Finley PR.Drug Interactions with Lithium: An Update.Clin Pharmacokinet.2016;55(8):925-941. doi:10.1007/s40262-016-0370-yAdditional ReadingMarples, David. About Lithium NDI. Diabetes Insipidus Foundation. 2003.McKnight RF, Adida, M, Budge, K, Stockton S, Goodwin, GM,Geddes, JR.Lithium Toxicity Profile: A Systematic Review and Meta-Analysis.The Lancet.20 Jan 2012.Roxane Laboratories. Lithium Official FDA Information, Side Effects and Uses. Drugs.com. Nov 2009.Thomsen HealthCare. Lithium Consumer Information.Drugs.com.

7 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Mohandas E, Rajmohan V.Lithium use in special populations.Indian J Psychiatry.2007;49(3):211-218. doi:10.4103/0019-5545.37325Coppen A.Lithium in unipolar depression and the prevention of suicide.J Clin Psychiatry. 2000;61 Suppl 9:52-56.Gitlin M.Lithium side effects and toxicity: prevalence and management strategies.Int J Bipolar Disord.2016;4(1):27. doi:10.1186/s40345-016-0068-yAmerio A, Ossola P, Scagnelli F, et al.Safety and efficacy of lithium in children and adolescents: A systematic review in bipolar illness.Eur Psychiatry.2018;54:85-97. doi:10.1016/j.eurpsy.2018.07.012Bedford JJ, Weggery S, Ellis G, et al.Lithium-induced nephrogenic diabetes insipidus: renal effects of amiloride.Clin J Am Soc Nephrol.2008;3(5):1324-1331. doi:10.2215/CJN.01640408Kibirige D, Luzinda K, Ssekitoleko R.Spectrum of lithium induced thyroid abnormalities: a current perspective.Thyroid Res. 2013;6(1):3. doi:10.1186/1756-6614-6-3Finley PR.Drug Interactions with Lithium: An Update.Clin Pharmacokinet.2016;55(8):925-941. doi:10.1007/s40262-016-0370-yAdditional ReadingMarples, David. About Lithium NDI. Diabetes Insipidus Foundation. 2003.McKnight RF, Adida, M, Budge, K, Stockton S, Goodwin, GM,Geddes, JR.Lithium Toxicity Profile: A Systematic Review and Meta-Analysis.The Lancet.20 Jan 2012.Roxane Laboratories. Lithium Official FDA Information, Side Effects and Uses. Drugs.com. Nov 2009.Thomsen HealthCare. Lithium Consumer Information.Drugs.com.

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Mohandas E, Rajmohan V.Lithium use in special populations.Indian J Psychiatry.2007;49(3):211-218. doi:10.4103/0019-5545.37325Coppen A.Lithium in unipolar depression and the prevention of suicide.J Clin Psychiatry. 2000;61 Suppl 9:52-56.Gitlin M.Lithium side effects and toxicity: prevalence and management strategies.Int J Bipolar Disord.2016;4(1):27. doi:10.1186/s40345-016-0068-yAmerio A, Ossola P, Scagnelli F, et al.Safety and efficacy of lithium in children and adolescents: A systematic review in bipolar illness.Eur Psychiatry.2018;54:85-97. doi:10.1016/j.eurpsy.2018.07.012Bedford JJ, Weggery S, Ellis G, et al.Lithium-induced nephrogenic diabetes insipidus: renal effects of amiloride.Clin J Am Soc Nephrol.2008;3(5):1324-1331. doi:10.2215/CJN.01640408Kibirige D, Luzinda K, Ssekitoleko R.Spectrum of lithium induced thyroid abnormalities: a current perspective.Thyroid Res. 2013;6(1):3. doi:10.1186/1756-6614-6-3Finley PR.Drug Interactions with Lithium: An Update.Clin Pharmacokinet.2016;55(8):925-941. doi:10.1007/s40262-016-0370-y

Mohandas E, Rajmohan V.Lithium use in special populations.Indian J Psychiatry.2007;49(3):211-218. doi:10.4103/0019-5545.37325

Coppen A.Lithium in unipolar depression and the prevention of suicide.J Clin Psychiatry. 2000;61 Suppl 9:52-56.

Gitlin M.Lithium side effects and toxicity: prevalence and management strategies.Int J Bipolar Disord.2016;4(1):27. doi:10.1186/s40345-016-0068-y

Amerio A, Ossola P, Scagnelli F, et al.Safety and efficacy of lithium in children and adolescents: A systematic review in bipolar illness.Eur Psychiatry.2018;54:85-97. doi:10.1016/j.eurpsy.2018.07.012

Bedford JJ, Weggery S, Ellis G, et al.Lithium-induced nephrogenic diabetes insipidus: renal effects of amiloride.Clin J Am Soc Nephrol.2008;3(5):1324-1331. doi:10.2215/CJN.01640408

Kibirige D, Luzinda K, Ssekitoleko R.Spectrum of lithium induced thyroid abnormalities: a current perspective.Thyroid Res. 2013;6(1):3. doi:10.1186/1756-6614-6-3

Finley PR.Drug Interactions with Lithium: An Update.Clin Pharmacokinet.2016;55(8):925-941. doi:10.1007/s40262-016-0370-y

Marples, David. About Lithium NDI. Diabetes Insipidus Foundation. 2003.McKnight RF, Adida, M, Budge, K, Stockton S, Goodwin, GM,Geddes, JR.Lithium Toxicity Profile: A Systematic Review and Meta-Analysis.The Lancet.20 Jan 2012.Roxane Laboratories. Lithium Official FDA Information, Side Effects and Uses. Drugs.com. Nov 2009.Thomsen HealthCare. Lithium Consumer Information.Drugs.com.

Marples, David. About Lithium NDI. Diabetes Insipidus Foundation. 2003.

McKnight RF, Adida, M, Budge, K, Stockton S, Goodwin, GM,Geddes, JR.Lithium Toxicity Profile: A Systematic Review and Meta-Analysis.The Lancet.20 Jan 2012.

Roxane Laboratories. Lithium Official FDA Information, Side Effects and Uses. Drugs.com. Nov 2009.

Thomsen HealthCare. Lithium Consumer Information.Drugs.com.

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