Top reasons to quit lithium include the inability to cope with the side effects like diarrhea and tremor, lithium toxicity, or when the drug interferes with other medication. You may also quit lithium when you get well.
Lithium has become a household name in treating bipolar disorder for more than half a century. It's also effective in managing ADHD and may reduce the risk of Alzheimer's in bipolar patients—the benefits of lithium are numerous.
But, like every other drug, lithium has its side effects and, understandably, it may not work effectively for everyone. As a result, it may be in your best interests to discontinue your treatment.
Let's consider the reasons to quit lithium in detail:
1. Inability to cope with lithium's side effects
Among the side effects of lithium, diarrhea, tremor, creatinine increase, frequent peeing, and weight gain are the top reasons patients quit lithium.
While not everyone will experience these effects, especially at subtherapeutic doses, they can be pretty worrisome for others. If you find yourself gaining weight, consider adding metformin to your psychiatric treatment, as it may reverse weight gain by reducing blood sugar levels.
2. Possibility of lithium toxicity
It's recommended to go for regular blood tests to determine your lithium levels. If the amount of lithium in your blood is too high, it may lead to lithium toxicity, prompting adverse effects. Some patients quit lithium because they're inconvenienced with having to go for tests all the time.
But the reality is, tests may not be as frequent if you're using lithium below standard therapeutic doses (i.e., below 0.6 mmol/L). Ideally, do a test at the beginning of treatment to establish this subtherapeutic dose. Also talk to your provider to figure out the safest frequency for you. .
3. Risks due to long-term lithium use
Long-term lithium use has been associated with thyroid and kidney disease, so it's best to discontinue treatment when you no longer experience the symptoms for which you started treatment.
Notwithstanding, using lithium at very low doses has been found to substantially reduce these risks while still being effective.
4. Lithium's potential for drug interactions
Other medications like nonsteroidal anti-inflammatory drugs (NSAIDs) and certain diuretics and antibiotics may interfere with lithium, leading to increased lithium levels in the body and potential toxicity.
If you're on lithium but need to use other drugs, speak with your healthcare provider to know the best direction to take.
5. Quit lithium if it doesn't work for you
While lithium can effectively manage psychiatric conditions, it may not work for everyone. Some individuals may not respond to the drug or may find its side effects too severe. These are valid reasons to consider discontinuing lithium drug and seek an alternative.
Lithium treatment should never be discontinued abruptly, as it can lead to a relapse. The NICE guideline is to gradually reduce your lithium dose over four weeks. Ideally, you can do this over a span of four months.
Do not abruptly stop lithium simply because you don't want to take the medication or because you "feel" well.
If you're considering quitting lithium, it's in your best interest to discuss it with your healthcare provider to come up with a safe and effective plan.
Got questions on lithium use or need help with a mental healh problem you've been battling? Reach out to us now and begin your journey to better mental well-being.