Lithium: Side Effects, Toxicity, and Monitoring Tests

Lithium is a medication prescribed to manage and prevent manic episodes in people with bipolar disorder. While it can be beneficial, it is important to understand the potential side effects and the importance of regular monitoring tests for safe and effective treatment.

Key Points About Lithium

• Lithium can cause serious side effects, and even slightly elevated levels can be harmful.
• Regular monitoring of lithium levels is essential for safe and effective treatment.

Potential Side Effects of Lithium

Lithium can cause a variety of side effects, some of which are common and mild, and others that are less common but potentially serious.

Common Side Effects

• Acne-like rash
• Appetite changes
• Diarrhea
• Dizziness
• Dry mouth
• Increased urination
• Hair loss or thinning
• Hand tremors
• Headache
• Increased thirst
• Nausea or vomiting
• Swelling (edema)

Weight gain is another common concern associated with lithium. It is important to discuss this with your healthcare provider if weight gain becomes significant or bothersome.

Serious Side Effects

If you experience any of the following, seek immediate medical attention:

• Blackouts or fainting
• Blurry vision
• Chest tightness or shortness of breath
• Confusion or hallucinations
• Slow or jerky movements
• Ringing in the ears or pounding head noises
• Seizures
• Speech problems
• Uncontrollable shaking

Lithium Toxicity

Elevated lithium levels can lead to toxicity. This can be categorized into three types:

• Acute Lithium Toxicity: Taking too much lithium at once.
• Chronic Lithium Toxicity: A gradual buildup of lithium over time due to prolonged use.
• Acute-on-Chronic Lithium Toxicity: Taking too much lithium on a day-to-day basis.

Toxicity can cause symptoms such as weakness, tremors, difficulty concentrating, and diarrhea in mild cases. In severe cases, vomiting, severe tremors, slurred speech, lethargy, and confusion may occur.

Lithium toxicity can be life-threatening and requires immediate treatment, potentially including hospitalization.

If you suspect lithium toxicity, call the Poison Helpline at 800-222-1222 or seek emergency medical attention immediately.

Drug Interactions With Lithium

Several substances can interact with lithium, potentially increasing its levels in the blood. These include:

• Angiotensin II receptor antagonists (ARBs) such as Diovan (valsartan) and Cozaar (losartan)
• Angiotensin-converting enzyme inhibitors (ACE inhibitors) such as Vasotec (enalapril) and Prinivil (lisinopril)
• Diuretics (water pills)
• Non-steroidal anti-inflammatory drugs (NSAIDs) such as Advil (ibuprofen) and