Potential Risks of Lithium Treatment You Need to Know

I have written extensively on lithium and its effectiveness in managing mood disorders, particularly Bipolar Disorder. It's also an excellent med for people with suicidal ideation, protects neurons in the brain, slows down aging, and may prevent Dementia.

However, like almost every other medication, it's not all rosy with lithium. It, too, has its side effects. But the good news is, you can significantly reduce the risks of side effects of lithium by using the drug in subtherapeutic doses.

But first, let's discuss some of these side effects

Common side effects of lithium

The common side effects of lithium are typically mild and go away by themselves. They're also more likely to occur when you start using the drug. And if you're on the right — subtherapeutic — dose, you may not have any issues using lithium. However, some people find that lithium makes them feel a bit numb and nauseous.

The common side effects of lithium include:

• Nausea
• Diarrhea
• Dry mouth
• Feeling thirsty often
• Urinating more often
• Metallic taste
• Hands shaking slightly
• Drowsiness

One possible reason for these side effects is that lithium affects the flow of sodium through nerves and muscles in the body. And sodium is associated with excitation.

Serious side effects

Rarely, you may experience severe side effects from lithium because there's too much of it in your blood. This is why it's crucial to have your blood tested regularly to ensure safe levels.

The serious side effects of lithium include the following:

• Blurred vision
• Feeling very thirsty and peeing more often than normal
• Feeling lightheaded
• Difficulty speaking
• Muscle spasms that may affect the face, eyes, or neck
• Feeling confused and blacking out

These are all symptoms of lithium toxicity, that is, when too much of it is in your blood that it becomes harmful. If you experience any of these side effects, call for help immediately.

Because lithium affects hydration and urination, when used over a long period, say 30-40 years, it may cause kidney damage and thyroid issues. But these side effects are typically at high doses. Even if you do get some kidney damage, it may be reversible. There are also medications to counteract the thyroid issues if they were to manifest.

How to manage lithium's side effects

Lithium taken in subtherapeutic doses significantly quells the risks of side effects. Anything below 0.6 mmol/L is considered subtherapeutic levels. And thankfully, much evidence supports that such low doses are pretty effective.

So, aim for as low a dose as does the job, preferably subtherapeutic levels, to prevent long-term adverse effects.

It's also good to drink plenty of fluids and minimize alcohol (as it can cause dehydration) when on lithium medication.

The best way to prevent problems is to check your blood lithium levels regularly for lithium toxicity. Also, check your thyroid levels. If the levels are just right, the risks of side effects are minimal. And if the levels rise at any point, your healthcare provider may suggest the best course of action.

Otherwise, lithium may prolong the life of organs overall.

Who can't take lithium?

While lithium is considered a miracle in psychiatry, not everyone is well-suited for this prescription. For example, lithium is not recommended in pregnant women, especially during the first trimester, where the risk of problems to the fetus is highest.

Nevertheless, your doctor may evaluate your health and determine if the benefits far outweigh the risks and may prescribe it to keep you well.

Lithium may not be recommended for you if:

• You have an allergic reaction to lithium
• You have kidney problems
• You have a cardiovascular disease
• You have hypothyroidism
• You have low levels of sodium in your body
• You need to undergo surgery
• You're trying to get pregnant or are breastfeeding
• You have Addison's disease
• You have Brugada syndrome

Again, none of these situations completely preclude you from using lithium. It's up to your doctor to evaluate the severity of your condition and weigh that against the benefits of the drug.

Author

Satu H. Woodland, PMHCNS-BC, APRN Satu Woodland is owner and clinician of Hope Mental Health, an integrative mental health practice located at Bown Crossing in Boise, Idaho. She sees children, adolescents, and adults.  Ms. Woodland with her background in nursing, prefers a holistic and integrative approach to mental health care that addresses the mind and body together. While Ms. Woodland provides medication management services in all her patients, she believes in long-lasting solutions that include a number of psychotherapies, namely cognitive behavioral therapy, exposure and response prevention therapy, attention to lifestyle, evidenced based alternative psychiatric care and spirituality. If you’d like to gain control over your mental health issues, call Hope Mental Health at 208-918-0958, or use the online scheduling tool to set up an initial consultation.