lithium

What is the most important information I should know about lithium?

Lithium toxicity (too much lithium in your body) can cause death. Lithium toxicity can occur if you take only slightly more than a recommended dose.

What is lithium?

Lithium is a mood stabilizer that is used to treat or control the manic episodes of bipolar disorder (manic depression). Manic symptoms include hyperactivity, rushed speech, poor judgment, reduced need for sleep, aggression, and anger. Lithium also helps to prevent or lessen the intensity of manic episodes.

Lithium is for use in adults and children at least 7 years old.

Lithium may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking lithium?

Tell your doctor if you have ever had:

• breathing problems;
• heart disease;
• kidney disease;
• a thyroid disorder;
• an abnormal electrocardiograph or ECG (sometimes called an EKG);
• fainting spells; or
• a family member who died before age 45.

Some medicines can interact with lithium and cause a serious condition called serotonin syndrome. Be sure your doctor knows if you also take stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. Ask your doctor before making any changes in how or when you take your medications.

How should I take lithium?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Never use lithium in larger amounts, or for longer than prescribed. Lithium overdose can occur if you take only slightly more than a recommended dose.

Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon).

It may take up to 3 weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not begin to improve after 1 week of treatment.

You may need frequent blood tests.

If you need surgery, tell the surgeon ahead of time that you are using lithium.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Early signs of lithium toxicity include: vomiting, diarrhea, drowsiness, muscle weakness, or loss of coordination.

What should I avoid while taking lithium?

Avoid becoming overheated or dehydrated during exercise, in hot weather, or by not drinking enough fluids. Follow your doctor's instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.

Do not change the amount of salt you consume in your diet. Changing your salt intake could change the amount of lithium in your blood.

What are the possible side effects of lithium?

Too much lithium in your body can cause death. Lithium toxicity can occur if you take only slightly more than a recommended dose.

• a light-headed feeling, like you might pass out;
• shortness of breath;
• fever, increased thirst or urination;
• weakness, dizziness or spinning sensation;
• memory problems, hallucinations;
• problems with balance or muscle movement;
• loss of bowel or bladder control;
• a seizure (blackout or convulsions);
• low sodium level --headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady;
• thyroid problems --weight gain or loss, muscle pain, tremors, feeling hot or cold, changes in your skin or hair, sweating, feeling weak or tired, fast or pounding heartbeats, increased bowel movements, feeling anxious or agitated;
• dehydration symptoms --feeling very thirsty or hot, being unable to urinate, heavy sweating, or hot and dry skin; or
• increased pressure inside the skull --severe headaches, ringing in your ears, dizziness, nausea, vision problems, pain behind your eyes.

Common side effects may include:

• dizziness, drowsiness;
• tremors in your hands;
• trouble walking;
• dry mouth, increased thirst or urination;
• nausea, vomiting, loss of appetite;
• rash; or
• blurred vision.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect lithium?

Tell your doctor about all your current medicines. Many drugs can affect lithium, especially:

• buspirone;
• fentanyl;
• St. John's wort;
• tramadol;
• a "triptan" migraine headache medicine;
• tryptophan;
• an antidepressant or antipsychotic medication; or
• an MAO inhibitor --isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

This list is not complete and many other drugs may affect lithium. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Where can I get more information?

Your pharmacist can provide more information about lithium.