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Overview: Lithium is commonly used to treat bipolar disorder. It may work by affecting certain chemicals in the brain that regulate mood. Common side effects include tremor, peeing a lot, thirst, dizziness, and blurred vision. Serious side effects may include kidney problems or thyroid problems. Do not drive or operate heavy machinery until you know how lithium affects you. Keep all appointments with your health care provider to check your blood work while taking lithium.

Uses

What is lithium used for?

Lithium is commonly used to treat manic and mixed episodes of bipolar I disorder and to help prevent symptoms from returning.

Lithium may also be used for other conditions as determined by your health care provider.

How does lithium work (mechanism of action)?

Lithium is a mood stabilizer. It may work by affecting certain chemicals in your brain that regulate mood, such as serotonin, dopamine, or norepinephrine. 

How is lithium supplied (dosage forms)?

Brands and other names

  • Eskalith
  • Lithane
  • Lithobid
  • Lithonate
  • Lithotabs

Dosage forms and strengths

  • 300 mg, 450 mg extended-release oral tablets
  • 150 mg, 300 mg, 600 mg oral capsules
  • 300 mg oral tablets
  • 300 mg (8 mEq)/5 mL oral solution

How should I store lithium?

Lithium should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place. Protect lithium tablets and capsules from moisture. 

Side Effects

What are the most common side effects of lithium?

The most common side effects of lithium are listed below. Your side effects may vary depending on your age. Tell your health care provider if you have any of these side effects that bother you.

  • Trembling of hands or tremor
  • Peeing a lot
  • Feeling thirsty
  • Nausea and vomiting
  • Discomfort
  • Thyroid problems (see below)
  • Dizziness
  • Rash
  • Trouble with balance, coordination, or walking
  • Decreased appetite
  • Blurry vision

There may be other side effects of lithium that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of lithium?

While less common, the most serious side effects of lithium are described below, along with what to do if they happen.

Severe Allergic Reactions. Lithium may cause allergic reactions, which can be serious. Stop taking lithium and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Lithium Toxicity. Too much lithium in the blood can lead to lithium toxicity. Some people may have symptoms of lithium toxicity even if lithium levels are within a normal range. The risk of lithium toxicity may be higher if you have a fever, take certain other medicines, or are dehydrated. Keep all appointments with your health care provider to check your lithium blood levels. This will help your health care provider find the right lithium dose for you. Stop taking lithium and call your health care provider right away if you have any of the following symptoms. 

  • Abnormal heart rhythm
  • Weak muscles or muscle twitching
  • Vomiting or diarrhea
  • Blurred vision
  • Clumsiness or lightheadedness
  • Drowsiness
  • Ringing in your ears
  • Confusion, mood changes, or slurred speech
  • Bloating
  • Breathing problems
  • Seizure

Kidney Problems. Lithium may cause kidney problems, including having to pee more often (polyuria) and excessive thirst (polydipsia). It may also affect how your kidneys work and could cause a condition called metabolic acidosis, where there is too much acid in your blood. Lithium may also cause a condition called chronic tubulointerstitial nephropathy (CTIN). Keep all appointments with your health care provider to check the health of your kidneys. Make sure you stay hydrated while taking lithium. Call your health care provider right away if you notice any of the following symptoms.

  • Peeing a lot
  • Swelling in your feet, ankles, or legs
  • Weakness or unusual tiredness
  • A hard time catching your breath or chest pain/pressure
  • Confusion
  • Nausea or vomiting
  • Seizures
  • Fast breathing or heartbeat
  • Headache
  • Not feeling hungry

Low Sodium Levels (Hyponatremia). Lithium may cause low sodium levels. Before starting lithium, talk to your health care provider about your water and salt intake. Call your health care provider if you have any of the following symptoms of a low sodium level.

  • Headache
  • Drowsiness
  • Muscle weakness or cramps
  • Nausea, vomiting, or loss of appetite
  • Tiredness or sleepiness
  • Dizziness
  • Weight gain
  • Restlessness or irritability
  • Change in your mental condition, such as hallucinations, confusion, decreased awareness, or alertness
  • Seizures

Serotonin Syndrome. Serotonin syndrome is when there is too much of a substance called serotonin in your body. Lithium can cause serotonin syndrome when it is taken alone or with other medicines that affect serotonin. This condition can be life-threatening. Get emergency help if you have any of the following symptoms of serotonin syndrome.

  • Sweating, fever, or flushing
  • Confusion
  • Feeling agitated or restless
  • Seeing or hearing unusual things
  • Dizziness
  • Fast or racing heartbeat
  • Nausea, vomiting, or diarrhea
  • Muscle twitching, stiffness, or tremor
  • Seizures

Thyroid Problems. Lithium can cause thyroid problems, which can cause high thyroid levels (hyperthyroidism) or low thyroid levels (hypothyroidism). Keep all appointments with your health care provider to have your blood checked. Call your health care provider if you have any of the following symptoms. 

  • Feeling nervous or anxious 
  • Mood swings
  • Trouble swallowing 
  • Swollen thyroid (goiter)
  • Changes in weight
  • Feeling cold 
  • Tiredness that does not go away or gets worse
  • Constipation

High Calcium Levels (Hypercalcemia). Lithium can cause high calcium levels, also called hypercalcemia. Hypercalcemia can lead to serious problems with your kidneys, heart, or bones. Keep all appointments with your health care provider to have your blood checked. Stop taking lithium and call your health care provider if you have any of the following symptoms.

  • Peeing frequently
  • Feeling thirsty
  • Tiredness
  • Confusion or dizziness
  • Poor appetite
  • Nausea or vomiting
  • Constipation
  • Muscle weakness
  • Bone pain
  • Abnormal heart rhythm

High Parathyroid Levels. Lithium can cause high parathyroid levels, also called hyperparathyroidism. Call your health care provider right away if you have any of the following symptoms.

  • Nausea and vomiting
  • Loss of appetite
  • Tiredness
  • Stomach pain
  • Bone and joint pain
  • Depression
  • Kidney stones

Increased Pressure Around the Brain. Lithium can increase the pressure around the brain, a serious condition called pseudotumor cerebri (or increased intracranial pressure). Stop taking lithium and call your health care provider right away if you have any of the following symptoms.

  • Dizziness
  • Nausea and vomiting
  • Severe headache
  • Vision changes
  • Ringing in the ears

Warnings & Precautions

Who should not use lithium?

Allergies to Ingredients. People who are allergic to any of the following should not take lithium.

  • Eskalith
  • Lithane
  • Lithium
  • Lithobid
  • Lithonate
  • Lithotabs
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific lithium products they stock.

What should I know about lithium before using it?

Do not take lithium unless it has been prescribed to you by a health care provider. Take it as prescribed.

Do not share lithium with other people, even if they have the same condition as you. It may harm them.

Keep lithium out of the reach of children.

Do not stop taking lithium without talking to your health care provider.

Lithium can make you sleepy and affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how lithium affects you.

Keep all appointments with your health care provider to get your blood drawn while taking lithium. Your health care provider will use these appointments to check the levels of lithium in your blood. This will tell your health care provider if your dose can stay the same or if it needs to be changed. Blood work can also help your health care provider make sure you are not having side effects from lithium.

Avoid becoming dehydrated while taking lithium, especially in hot weather or while exercising. Talk to your health care provider about how to stay hydrated and how much liquid to drink. In some cases, drinking too much liquid may also be unsafe. 

Do not change the amount of salt in your diet without talking to your health care provider. Changing the amount of salt you eat may affect your lithium levels.

There are multiple forms of lithium available. Read and follow the instructions for the product you have and make sure you understand how to use it properly. If you have any questions, talk to your health care provider.

Do not chew, cut, or crush lithium extended-release tablets.

Use an accurate measuring device to measure your dose of lithium oral liquid. A household spoon is not an accurate measuring device and may cause you to take the wrong dose. Ask your pharmacist what measuring device to use.

What should I tell my health care provider before using lithium?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if lithium is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

Fluid Loss. Talk to your health care provider if you have been sweating a lot or have a fever or diarrhea. Changes in the salt and water levels in your body can affect the lithium levels in your blood. 

Other Medicines and Supplements. Lithium may interact with other medicines and supplements. Before taking lithium, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. Lithium may cause harm to an unborn baby. Tell your health care provider if you are pregnant or plan to become pregnant. Your health care provider will let you know if you should take lithium while you are pregnant or trying to get pregnant.

Breastfeeding. Lithium can pass into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should stop breastfeeding or stop lithium.

Interactions

Does lithium interact with foods or drinks?

There are no known interactions between lithium and foods or drinks.

It is unknown if drinking alcohol will affect lithium. The risk of dizziness, balance problems, and blurry vision may be increased if you drink alcohol while taking lithium.

Does lithium interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking lithium.

  • Acetazolamide (Diamox), which is a medicine that may be used to treat fluid retention, glaucoma, or altitude sickness
  • Iodine or potassium iodide
  • Methyldopa, which is a medicine used to reduce blood pressure
  • Metronidazole (Flagyl), which is a medicine used to treat certain infections 
  • Sodium bicarbonate, which is a medicine used for heartburn and stomach ulcers and is in some over-the-counter (OTC) and prescription medicines, such as Zegerid, Zegerid OTC, and Alka-Seltzer
  • St. John’s wort, which is a supplement that may be used for depression
  • Tryptophan, which is a supplement that may be used to help the body make proteins and certain brain-signaling chemicals
  • A diuretic, also called a water pill, which is a medicine used to reduce edema (fluid retention) and blood pressure
  • Any medicine for depression or anxiety, including a selective serotonin reuptake inhibitor (SSRI), or a serotonin and norepinephrine reuptake inhibitor (SNRI), or buspirone
  • A monoamine oxidase inhibitor (MAOI), which is a medicine usually used for depression or Parkinson’s disease
  • An antipsychotic, which is a medicine for certain mental health conditions
  • Any medicine for seizures, such as carbamazepine or phenytoin
  • A nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen, naproxen, and others, which is in many prescription and OTC products for pain, swelling, and fever
  • An angiotensin-converting enzyme (ACE) inhibitor (such as enalapril or lisinopril) or an angiotensin II receptor blocker (ARB, such as losartan or valsartan), which is a medicine for high blood pressure, heart failure, and other heart conditions
  • A calcium channel blocker, such as amlodipine (Norvasc), diltiazem (Cardizem CD and others), or verapamil (Verelan, Verelan PM), which is a medicine used for high blood pressure or other conditions
  • A sodium-glucose cotransporter 2 (SGLT2) inhibitor, such as canagliflozin (Invokana), dapagliflozin (Farxiga), or empagliflozin (Jardiance)
  • A triptan, such as eletriptan (Relpax), sumatriptan (Imitrex and others), and others, which is a medicine commonly used to treat migraines
  • An opioid, such as fentanyl or tramadol, which is a medicine used to treat certain types of pain

Many other medicines may alter the blood levels of lithium. Tell your health care provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with lithium. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much lithium?

If you or someone else has used too much lithium, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of lithium?

It is important not to miss or skip doses of lithium. If you miss a dose, call your health care provider for advice. Do not take double or extra doses.