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Lithium

A gold-standard mood stabilizer for bipolar disorder that also lowers suicide risk. It works well but needs regular blood tests to stay in a safe range.

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What It Is

Lithium is one of the most effective treatments for bipolar disorder and is unique in lowering the risk of suicide.

It has a narrow safe range, so we keep the level in a target zone with regular blood tests.

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How to Take It & Salt/Fluids

Take with food to ease stomach upset. Keep your salt and fluid intake steady day to day.

Dehydration, low-salt diets, heavy sweating, vomiting, or diarrhea can raise your level into a dangerous range — drink enough water and call us if you get sick.

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Black Box Warning

Lithium toxicity can happen at levels close to the helpful range. Reliable blood testing must be available.

Warning signs of toxicity: coarse tremor, vomiting/diarrhea, slurred speech, unsteadiness, drowsiness, confusion — stop and call us or seek care.

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Common (Usually Mild) Side Effects

  • Fine hand tremor.
  • Increased thirst and urination.
  • Nausea, weight gain.
  • Acne.

Serious — Call Us or Seek Care

  • Signs of toxicity (see above) — treat as urgent.
  • Underactive thyroid: fatigue, cold intolerance, weight gain.
  • Kidney effects: passing large amounts of urine and constant thirst.
  • High calcium (from parathyroid changes).
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Alcohol & Interactions

Limit alcohol — it can dehydrate you and shift your level.

Avoid NSAIDs (ibuprofen, naproxen) unless approved — they raise lithium levels. Same for some blood-pressure medicines. Check before adding anything new.

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Required Monitoring

Lithium blood level — after dose changes and then every 6–12 months (drawn ~12 hours after your last dose)
Kidney function (creatinine)
Thyroid (TSH)
Calcium
Tell us if you become pregnant — lithium needs special planning.

This is general information, not a substitute for your prescriber's advice. Never start, stop, or change a dose on your own — some of these medicines need a slow, supervised taper. Bring this sheet to your appointments and ask questions.